Organization
PARKSIDE MEDICAL CONSULTANTS LLC
Active
Other names
MAGNOLIA MEDICAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARGO JOHANNA MUNIZ MD RPH (OWNER)
(803) 649-6366
Entity
Organization
Contact information
Practice address
410 UNIVERSITY PKWY, SUITE 2300, AIKEN, SC 29801-6807
(803) 649-6366
(803) 649-6347
Mailing address
PO BOX 2037, AIKEN, SC 29802
(803) 649-6366
(803) 649-6347
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22170
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4538
—
SC
Enumeration date
10/17/2006
Last updated
05/20/2008
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