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Organization
GEORGETOWN PEDIATRIC CENTER, PC
Active
Organization
GEORGETOWN PEDIATRIC CENTER, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL J HLETKO MD (PRESIDENT)
(843) 546-8686
Entity
Organization
Contact information
Practice address
57 JESSAMINE AVE, GEORGETOWN, SC 29440-5837
(843) 546-8686
(843) 546-1353
Mailing address
PO BOX 618, GEORGETOWN, SC 29442-0618
(843) 546-8686
(843) 546-1356
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
14532
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0557
—
SC
05
—
RHC031
—
SC
Enumeration date
07/19/2007
Last updated
03/18/2009
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