| NPI | 1861175697 |
|---|---|
| Doing Business As | PROACTIVE MD |
| Entity Type | Organization |
| Authorized Contact | MARK KEMBLE Cmo 864-501-0751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-08-09 |
| Last Update Date | 2026-06-29 |