Organization
PALMETTO PEDIATRIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY J HART (PRACTICE MANAGER)
(803) 788-6146
Entity
Organization
Contact information
Practice address
74 POLO RD, COLUMBIA, SC 29223-2806
(803) 788-6146
(803) 462-0312
Mailing address
74 POLO RD, COLUMBIA, SC 29223-2806
(803) 788-6146
(803) 462-0312
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0803
—
SC
Enumeration date
08/09/2006
Last updated
08/22/2020
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