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Individual

JULIANA MAVELLIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
370 S PIKE W, SUMTER, SC 29150-2664
(803) 774-4500
(803) 774-4629
Mailing address
550 S PIKE W, SUMTER, SC 29150-2616
(803) 324-6975
(803) 324-6975

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
94429
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
944296
SC
Enumeration date
03/30/2022
Last updated
08/13/2025
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