Provider Demographics
NPI:1689640922
Name:BELL, GARY BERNARD (MD)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:BERNARD
Last Name:BELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2899
Mailing Address - Country:US
Mailing Address - Phone:864-522-8611
Mailing Address - Fax:
Practice Address - Street 1:3010 FARROW RD STE 300A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-7603
Practice Address - Country:US
Practice Address - Phone:803-434-6100
Practice Address - Fax:803-434-3175
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC011980207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC119801Medicaid
SCP00761897OtherMEDICARE RAILROAD PTAN
SCC611245730Medicare PIN
SCP00761897OtherMEDICARE RAILROAD PTAN