Organization
PALMETTO MOON ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDSEY ANNE CLARK CRNA (EMPLOYEE/MEMBER)
(843) 861-3671
Entity
Organization
Contact information
Practice address
3045 ST. MATTHEWS RD., ORANGEBURG, SC 29118
(843) 861-3671
(803) 490-1571
Mailing address
307 WINDING BROOK DR, CAMERON, SC 29030-8347
(843) 861-3671
(803) 490-1571
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
3877
SC
Other
Enumeration date
03/13/2018
Last updated
03/13/2018
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