Proactive MD Nc, PC
Clinic/Center, Primary Care in Mocksville, NC. Organization (NPI-2).
NPI number1154036713
StatusActive
Last updated in NPPESAug 31, 2026
Details
- NPI
- 1154036713
- Entity type
- Organization (NPI-2)
- Legal business name
- Proactive MD Nc, PC
- Organization subpart
- No
- Enumeration date
- Jan 18, 2023
- Certification date
- Aug 31, 2026
- Last updated
- Aug 31, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | – | – | Yes |
Other names
- Proactive MD - Brakebush Health Center - Mocksville (Doing Business As)
Practice location
251 Eaton RdMocksville, NC 27028-8653
Phone 864-501-0751
Mailing address
86 Villa Rd Ste 100Greenville, SC 29615-3052
Phone 864-640-8355
Authorized official
Mark Allen Kemble
Cmo
8646408355
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