Provider Demographics
NPI:1922038413
Name:SEYMOUR, ZACHARY GREGG (MD)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:GREGG
Last Name:SEYMOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:803 N FANT ST
Mailing Address - Street 2:SUITE 2 B
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621-5700
Mailing Address - Country:US
Mailing Address - Phone:864-225-1481
Mailing Address - Fax:864-225-1879
Practice Address - Street 1:803 N FANT ST
Practice Address - Street 2:SUITE 2 B
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-5700
Practice Address - Country:US
Practice Address - Phone:864-225-1481
Practice Address - Fax:864-225-1879
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2008-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC15171207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC151710Medicaid
SC151710Medicaid