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Organization
EDISTO MULTISPECIALTY ASSOCIATES INC
Active
Organization
EDISTO MULTISPECIALTY ASSOCIATES INC
Active
Other names
dba Edisto Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT ENGLAND (COORDINATOR)
(800) 661-3365
Entity
Organization
Contact information
Practice address
302 MEDICAL PARK DR, SUITE 211, WALTERBORO, SC 29488-5747
(843) 549-0787
(843) 549-6867
Mailing address
302 MEDICAL PARK DR, SUITE 211, WALTERBORO, SC 29488-5747
(843) 549-0787
(843) 549-6867
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
NULL
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC508/GP3156
—
SC
Enumeration date
10/17/2005
Last updated
08/29/2007
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