1881524189 NPI number — MARK ALLEN KEMBLE AND NICOLAS PALACIOS MEZA PHYSICIANS PC

Table of content: (NPI 1881524189)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881524189 NPI number — MARK ALLEN KEMBLE AND NICOLAS PALACIOS MEZA PHYSICIANS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARK ALLEN KEMBLE AND NICOLAS PALACIOS MEZA PHYSICIANS PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881524189
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/20/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 VILLA RD STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29615-3052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-501-0751
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 VESEY ST FL 18
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10281-1053
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-501-0751
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/20/2026

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KEMBLE
Authorized Official First Name:
MARK
Authorized Official Middle Name:
Authorized Official Title or Position:
CMO
Authorized Official Telephone Number:
864-501-0751

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)