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Organization

PEDIATRIC ASSOCIATES OF ANDERSON, P.A.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
KEITH M HART M.D. (M.D.)
(864) 224-1055
Entity
Organization

Contact information

Practice address
2000 E GREENVILLE ST, SUITE 3000, ANDERSON, SC 29621-1580
(864) 224-1055
(864) 224-3773
Mailing address
2000 E GREENVILLE ST, SUITE 3000, ANDERSON, SC 29621-1580
(864) 224-1055
(864) 224-3773

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12019
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000400265C
GA.MEDICAID
GA
05
GP2927
SC
Enumeration date
03/28/2006
Last updated
08/16/2010
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