Individual
ANDREA M PEZZELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
115 MIDLANDS CT, WEST COLUMBIA, SC 29169-3456
(803) 457-7000
(803) 457-7001
Mailing address
109 MIDLANDS CT, SUITE A, WEST COLUMBIA, SC 29169-3456
(803) 457-7000
(803) 457-7001
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
204555
MA
207V00000X
Obstetrics & Gynecology Physician
29701
SC
207VG0400X
Gynecology Physician
Primary
29701
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0120961
MEDICAID WELFARE
—
05
—
0120961
—
MA
01
—
042472266
ONE HEALTH PLAN
—
01
—
0700410
EVERCARE
—
01
—
1009200
CIGNA HEALTH PLAN
—
01
—
160049837
RAILROAD MEDICARE
—
01
—
37554
HEALTHY START
—
01
—
45822
FALLON COMMUNITY HEALTH P
—
01
—
7099315
AETNA US HEALTHCARE
—
01
—
784225
MVP HEALTH CARE
—
01
—
A31235
MEDICARE B
—
01
—
AA3715
HARVARD PILGRIM HEALTH CA
—
01
—
J22633
BLUE CARE ELECT
—
Enumeration date
03/11/2006
Last updated
10/10/2017
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