Provider Demographics
NPI:1700805892
Name:POWERS, JOHN S (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:S
Last Name:POWERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1 INDEPENDENCE PT
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4545
Mailing Address - Country:US
Mailing Address - Phone:864-455-7000
Mailing Address - Fax:
Practice Address - Street 1:701 GROVE RD
Practice Address - Street 2:GMH ER ADMINISTRATION
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-5611
Practice Address - Country:US
Practice Address - Phone:864-454-0888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC10947207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC930082016OtherMEDICARE RAILROAD
SC57-6007863OtherAETNA
SC20031678OtherSELECT HEALTH GRP
SC20-10947OtherSTATE CONT SUBST
SC20009789OtherSELECT HEALTH IND
SC576007863OtherCIGNA
SC576007863OtherBLUE CROSS
SC109475Medicaid
SC576007863OtherBLUE CHOICE
SC576007863OtherBLUE CHOICE
SCC81758Medicare UPIN