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Organization
PLANTATION PEDIATRICS, LLC
Active
Organization
PLANTATION PEDIATRICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC RADABAUGH MBA (CFO)
(843) 766-6308
Entity
Organization
Contact information
Practice address
1871 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 766-6308
(843) 804-9883
Mailing address
1871 SAVAGE RD, CHARLESTON, SC 29407-4726
(843) 766-6308
(843) 804-9883
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
—
GP7269
—
SC
Enumeration date
01/25/2016
Last updated
02/03/2017
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