Provider Demographics
NPI:1083431928
Name:CLOW MEDICAL GROUP LLC
Entity type:Organization
Organization Name:CLOW MEDICAL GROUP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-581-7480
Mailing Address - Street 1:1100 RUTHERFORD RD STE B
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29609-3945
Mailing Address - Country:US
Mailing Address - Phone:865-581-7480
Mailing Address - Fax:864-532-4299
Practice Address - Street 1:1100 RUTHERFORD RD STE B
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-3945
Practice Address - Country:US
Practice Address - Phone:865-581-7480
Practice Address - Fax:864-532-4299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-23
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty