Provider Demographics
NPI:1316284300
Name:PARTNERMD SOUTH CAROLINA, P.C.
Entity type:Organization
Organization Name:PARTNERMD SOUTH CAROLINA, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:MUMPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:804-282-2655
Mailing Address - Street 1:7001 FOREST AVE STE 302
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23230-1726
Mailing Address - Country:US
Mailing Address - Phone:804-282-2655
Mailing Address - Fax:
Practice Address - Street 1:3535 PELHAM RD STE 101
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29615-4108
Practice Address - Country:US
Practice Address - Phone:864-315-1300
Practice Address - Fax:864-315-1301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-10
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMD9313207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty