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Organization
CHESTERFIELD CLINIC CORP
Active
Organization
CHESTERFIELD CLINIC CORP
Active
Parent organization
CHESTERFIELD CLINIC CORP
Other names
Palmetto Orthopedics Practice
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHESTERFIELD CLINIC CORP
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
715 S DOCTORS DR, SUITE F, CHERAW, SC 29520-7113
(843) 537-1111
(843) 537-9393
Mailing address
715 S DOCTORS DR, SUITE F, CHERAW, SC 29520-7113
(843) 537-1111
(843) 537-9393
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG3996
RR MEDICARE
SC
05
—
GP1883
—
SC
Enumeration date
11/30/2006
Last updated
02/28/2008
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