Organization
RICE PLANTER PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHERYL ANTIONETTE GRANT MD (OWNER)
(843) 509-5848
Entity
Organization
Contact information
Practice address
416 ROBERTSON BLVD, STE D, WALTERBORO, SC 29488-2952
(843) 782-5437
(843) 782-4269
Mailing address
317 WINTERGREEN RD, WALTERBORO, SC 29488-9512
(843) 782-5437
(843) 782-4269
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
25971
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
259712
—
SC
Enumeration date
09/13/2007
Last updated
09/13/2007
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