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Individual

CANDACE WHITFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
21 S SHIRLEY AVE, HONEA PATH, SC 29654-1503
(864) 512-7879
(864) 512-7037
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 369-0552
(864) 369-1826

Taxonomy

Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
18773
SC
363L00000X
Nurse Practitioner
Primary
18873
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
NP2827
SC
01
SC32386608
MEDICARE
01
SC32387482
MEDICARE
SC
Enumeration date
04/24/2014
Last updated
01/05/2023
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