Provider Demographics
NPI:1205890670
Name:GRATE, DEBORAH J (MD)
Entity type:Individual
Prefix:
First Name:DEBORAH
Middle Name:J
Last Name:GRATE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:313 MAIN ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646-2757
Mailing Address - Country:US
Mailing Address - Phone:864-388-0301
Mailing Address - Fax:864-388-0648
Practice Address - Street 1:219 GREENWOOD HWY
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:SC
Practice Address - Zip Code:29138-1143
Practice Address - Country:US
Practice Address - Phone:864-445-2181
Practice Address - Fax:864-445-9445
Is Sole Proprietor?:No
Enumeration Date:2006-04-13
Last Update Date:2013-09-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC12447207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCFQC018Medicaid
SCFQC018Medicaid