Organization
T. DANIEL CADDELL MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TITUS DANIEL CADDELL MD,PA (DOCTOR)
(864) 834-4191
Entity
Organization
Contact information
Practice address
907 NORTH MAIN STREET, TRAVELERS REST, SC 29690
(864) 834-4191
(864) 834-1964
Mailing address
PO BOX 1054, TRAVELERS REST, SC 29690-1054
(864) 834-4191
(864) 834-1964
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12475
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12475
LICENSE
SC
Enumeration date
05/22/2007
Last updated
08/22/2020
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