Organization
CAROLINA PEDIATRICS & ADOLESCENT CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PHILIP F. MUBARAK M. D. (PHYSICIAN)
(803) 256-0531
Entity
Organization
Contact information
Practice address
2113 ADAMS GRV, SUITE 101, COLUMBIA, SC 29203-7102
(803) 256-0531
(803) 765-9052
Mailing address
2113 ADAMS GRV, SUITE 101, COLUMBIA, SC 29203-6951
(803) 256-0531
(803) 765-9052
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
12782
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0094
—
SC
Enumeration date
03/21/2006
Last updated
10/13/2017
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