# CHESTERFIELD CLINIC CORP

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** CHESTERFIELD CLINIC CORP
- **Other names:** Carolina Pediatrics
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1346262961
- **Legal business name:** CHESTERFIELD CLINIC CORP
- **Authorized official:** DEBBIE T BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
- **Authorized official phone:** (615) 465-7626

## Contact information

- **Practice address:** 309 CLYDE AVE, CHERAW, SC 29520-3029
- **Practice address phone:** (843) 921-1211
- **Mailing address:** 309 CLYDE AVE, CHERAW, SC 29520-3029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/24/2006
- **Last updated:** 09/20/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4534 | — | SC |