Individual
DR. CHARLES DAVID PETIT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3010 FARROW RD, SUITE 300, COLUMBIA, SC 29203-7607
(803) 434-1210
(803) 434-1212
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 296-7305
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
13746
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137462
—
SC
Enumeration date
03/14/2006
Last updated
02/01/2013
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