Organization
CHESTERFIELD CLINIC CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEBBIE T BREWER (DIRECTOR PROVIDER ENROLLMENT)
(615) 465-7626
Entity
Organization
Contact information
Practice address
715 S DOCTORS DR, SUITE B, CHERAW, SC 29520-7113
(843) 537-3622
Mailing address
715 S DOCTORS DR, SUITE B, CHERAW, SC 29520-7113
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RN0300X
Nephrology Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5900377
—
NC
05
—
5950778
—
NC
05
—
5950784
—
NC
05
—
GP1883
—
SC
05
—
GP4535
—
SC
Enumeration date
07/07/2006
Last updated
07/20/2011
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