# THE PEDIATRIC CLINIC, P.A.

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

## Provider details

- **NPI number:** 1811995111
- **Authorized official:** MRS. PEGGY C. THOMAS (OFFICE MANAGER)
- **Authorized official phone:** (803) 536-2725

## Contact information

- **Practice address:** 940 HOLLY ST NE, ORANGEBURG, SC 29115-4930
- **Practice address phone:** (803) 536-2725
- **Practice address fax:** (803) 534-1441
- **Mailing address:** 940 HOLLY ST NE, ORANGEBURG, SC 29115-4930
- **Mailing address phone:** (803) 536-2725
- **Mailing address fax:** (803) 534-1441

## Taxonomy

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

## Other

- **Enumeration date:** 07/11/2005
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | GP0966 | — | SC |