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Contact Information

PRISMA HEALTH UNIVERSITY MEDICAL GROUP
1025 VERDAE BLVD
SUITE A
GREENVILLE, SC29607-4032
 Phone: 864-242-4683
 Fax: 864-240-8104
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Cardiovascular Disease

207RC0000X 11 Physician/Internal Medicine
 

Endocrinology, Diabetes & Metabolism

207RE0101X 11 Physician/Internal Medicine
 

Gastroenterology

207RG0100X 10 Physician/Gastroenterology
 

Rheumatology

207RR0500X 11 Physician/Internal Medicine
 

Surgery

208600000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for PRISMA HEALTH UNIVERSITY MEDICAL GROUP

NPI # 1083787006
LBN Legal business name PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Authorized official POLLY MILLER - (VP OF PAYOR STRATEGIES & ALIGNMENT)
Entity Organization
Organization subpart 1 No
Enumeration date 11/16/2006
Last updated 08/20/2020 - About 6 years ago
Identifiers
SC Medicaid GP4671
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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