Provider Demographics
NPI:1447289624
Name:GREENWOOD INTERNAL MED
Entity type:Organization
Organization Name:GREENWOOD INTERNAL MED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:P
Authorized Official - Last Name:CONE
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:864-227-6641
Mailing Address - Street 1:115 OVERLAND DR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-4053
Mailing Address - Country:US
Mailing Address - Phone:864-227-6641
Mailing Address - Fax:864-227-3953
Practice Address - Street 1:115 OVERLAND DR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646-4053
Practice Address - Country:US
Practice Address - Phone:864-227-6641
Practice Address - Fax:864-227-3953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-01
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4755174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC4755Medicare ID - Type Unspecified