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Contact Information

NEXTPHASEMD
107 W COLLEGE AVE
HARTSVILLE, SC29550-4113
 Phone: 843-861-2726
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Medical Specialty

261QM2500X
Indicates primary specialty

NPI Profile & details for NEXTPHASEMD

NPI # 1225492168
LBN Legal business name NEXTPHASEMD
Authorized official MICHELLE QUAYE - (CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 04/06/2016
Last updated 04/06/2016 - About 10 years ago
Identifiers
SC License # 22891
SC Medicaid 228916
SC Other SC 2958B578 PTAN
SC Other 22891 SC STATE LICENSE
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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