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Organization
CHESTERFIELD CLINIC CORP
Active
Organization
CHESTERFIELD CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
721 CHESTERFIELD HWY, CHERAW, SC 29520-7002
(843) 921-1211
(843) 921-1213
Mailing address
721 CHESTERFIELD HWY, CHERAW, SC 29520-7002
(843) 921-1211
(843) 921-1213
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3612
—
SC
Enumeration date
05/27/2005
Last updated
11/29/2007
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