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Organization

CHESTERFIELD CLINIC CORP

Active
Parent organization
CHESTERFIELD CLINIC CORP
Other names
Palmetto Orthopedics Practice
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHESTERFIELD CLINIC CORP
Authorized official
DEBBIE BREWER (DIRECTOR OF PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization

Contact information

Practice address
715 S DOCTORS DR, SUITE F, CHERAW, SC 29520-7113
(843) 537-1111
(843) 537-9393
Mailing address
715 S DOCTORS DR, SUITE F, CHERAW, SC 29520-7113
(843) 537-1111
(843) 537-9393

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
CG3996
RR MEDICARE
SC
05
GP1883
SC
Enumeration date
11/30/2006
Last updated
02/28/2008
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