Organization
ANGEL OAK PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KELLI E JOHNSTON DO (PEDIAATRICIAN/OWNER)
(248) 760-4587
Entity
Organization
Contact information
Practice address
1834 BLUEBIRD RD OFC 7, JOHNS ISLAND, SC 29455-8308
(843) 894-3490
Mailing address
2911 WATERLEAF RD, JOHNS ISLAND, SC 29455-3176
(248) 760-4587
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
261Q00000X
Clinic/Center
—
—
Other
Enumeration date
11/20/2023
Last updated
03/30/2024
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