| NPI | 1477621266 |
|---|---|
| Doing Business As | EASTSIDE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | WILBUR R GAY CFO 864-605-3762 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207Q00000X Family Medicine (Licence: SC 149672) | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2019-07-02 |