# CHILDRENS CHOICE PEDIATRICS PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528122884
- **Authorized official:** DR. THOMAS FRANCIS BRADY M.D. (MEMBER PEDIATRICAN)
- **Authorized official phone:** (803) 647-1265

## Contact information

- **Practice address:** 6108 GARNERS FERRY RD, COLUMBIA, SC 29209-1401
- **Practice address phone:** (803) 647-1265
- **Practice address fax:** (803) 647-1266
- **Mailing address:** 6108 GARNERS FERRY RD, COLUMBIA, SC 29209-1401
- **Mailing address phone:** (803) 647-1265
- **Mailing address fax:** (803) 647-1266

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 17166 | SC | Yes |

## Other

- **Enumeration date:** 12/21/2006
- **Last updated:** 07/09/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP4126 | — | SC |