Provider Demographics
NPI:1841482148
Name:MARGA F. MASSEY, MD, LLC
Entity type:Organization
Organization Name:MARGA F. MASSEY, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD
Authorized Official - Prefix:
Authorized Official - First Name:MARGA
Authorized Official - Middle Name:F
Authorized Official - Last Name:MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:866-446-0962
Mailing Address - Street 1:125 DOUGHTY ST STE 550
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5788
Mailing Address - Country:US
Mailing Address - Phone:866-446-0962
Mailing Address - Fax:866-446-0962
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:SUITE 590
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403
Practice Address - Country:US
Practice Address - Phone:866-446-0962
Practice Address - Fax:803-656-9880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-10
Last Update Date:2018-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29224174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H11424Medicare UPIN