# PEDIATRIC ASSOCIATES OF ANDERSON, P.A.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013978303
- **Authorized official:** KEITH M HART M.D. (M.D.)
- **Authorized official phone:** (864) 224-1055

## Contact information

- **Practice address:** 2000 E GREENVILLE ST, SUITE 3000, ANDERSON, SC 29621-1580
- **Practice address phone:** (864) 224-1055
- **Practice address fax:** (864) 224-3773
- **Mailing address:** 2000 E GREENVILLE ST, SUITE 3000, ANDERSON, SC 29621-1580
- **Mailing address phone:** (864) 224-1055
- **Mailing address fax:** (864) 224-3773

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 12019 | SC | Yes |

## Other

- **Enumeration date:** 03/28/2006
- **Last updated:** 08/16/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000400265C | GA.MEDICAID | GA |
| 05 | — | GP2927 | — | SC |