Provider Demographics
NPI:1356449359
Name:PIEDMONT SPINE AND NEUROSURGICAL GROUP, P.A.
Entity Type:Organization
Organization Name:PIEDMONT SPINE AND NEUROSURGICAL GROUP, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:N
Authorized Official - Last Name:BUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-224-5700
Mailing Address - Street 1:109 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-3333
Mailing Address - Country:US
Mailing Address - Phone:864-224-5700
Mailing Address - Fax:864-226-0680
Practice Address - Street 1:109 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-3333
Practice Address - Country:US
Practice Address - Phone:864-224-5700
Practice Address - Fax:864-226-0680
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2009-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1073561171OtherGARY W. MORSE, PA-C INDIVIDUAL NPI
SC1508853094OtherDR. RUSSELL INDIVIDUAL NPI
SC1073561171OtherGARY W. MORSE, PA INDIVIDUAL NPI #
SC1821057530OtherD. MARK MELTON INDIVIDUAL NPI
SCMPA967Medicaid
SC1093727653OtherCHRISTOPHER JOHNSON, PA-C INDIVIDUAL NPI
SC1194737726OtherCHRISTIE B. MINA, MD INDIVIDUAL NPI
SCCI4666OtherMEDICARE RAILROAD
SC1568470904OtherMICHAEL BUCCI, MD INDIVIDUAL NPI
SC1649282245OtherAARON C. MACDONALD, MD INDIVIDUAL NPI
SC1568470904OtherMICHAEL BUCCI, MD INDIVIDUAL NPI