Gravely, Vonda K
Gravely, Vonda K is an individual health care provider with primary practice located at 250 Dewey Ave , Spartanburg SC 29303-3009. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Gravely, Vonda K can be contacted via phone (864) 585-0366.Contact Information
Primary practice address
250 Dewey Ave
Spartanburg SC 29303-3009
Phone: (864) 585-0366
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Psychiatry | 2084P0800X | 21107 | South Carolina |
Profile Details
| NPI number | 1053382259 |
|---|---|
| LBN Legal business name | Gravely, Vonda K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 27th, 2006 |
| Last updated | Mar 9th, 2020 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053382259 | NPPES |
| North Carolina | MEDICAID | 5905213 | |
| North Carolina | MEDICAID | 211078 | |
| North Carolina | Other | C7069 |
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