Organization
EDGEFIELD MEDICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARI M REEL (OFFICE MANAGER)
(803) 637-3146
Entity
Organization
Contact information
Practice address
200 RIDGE MEDICAL PLAZA RD, EDGEFIELD, SC 29824-4530
(803) 637-3146
(803) 637-3169
Mailing address
200 RIDGE MEDICAL PLAZA RD, EDGEFIELD, SC 29824-4530
(803) 637-3146
(803) 637-3169
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207Q00000X
TAXONOMY
SC
05
—
PA0267
—
SC
Enumeration date
08/23/2006
Last updated
05/15/2013
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