Basic Information
| Provider Information | |||||||||
| NPI: | 1275657694 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SAVAGE-JETER | ||||||||
| FirstName: | ERICA | ||||||||
| MiddleName: | LACHE' | ||||||||
| NamePrefix: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1855 E MAIN ST STE 21A | ||||||||
| Address2: | |||||||||
| City: | SPARTANBURG | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293072327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8649134370 | ||||||||
| FaxNumber: | 8339941103 | ||||||||
| Practice Location | |||||||||
| Address1: | 1855 E MAIN ST STE 21A | ||||||||
| Address2: | |||||||||
| City: | SPARTANBURG | ||||||||
| State: | SC | ||||||||
| PostalCode: | 293072327 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8649134370 | ||||||||
| FaxNumber: | 8339941103 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 12/14/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | LL 29051 | SC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 290517 | 05 | SC | MEDICAID | P00803813 | 01 | SC | MEDICARE RAIL ROAD | OTHER |