Organization
COASTAL PEDIATRIC ASSOCIATES, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT ANDREW CLIFFORD M.D. (PARTNER)
(843) 573-2535
Entity
Organization
Contact information
Practice address
2067 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5834
(843) 573-2535
(843) 573-2534
Mailing address
4975 LACROSS RD STE 150, NORTH CHARLESTON, SC 29406-6531
Taxonomy
Speciality
Code
Description
License number
State
103TH0100X
Health Service Psychologist
—
—
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4680
—
SC
05
—
GP4716
—
SC
05
—
GP7882
—
SC
05
—
GP8203
—
SC
05
—
GP8228
—
SC
05
—
GP8229
—
SC
05
—
GP8237
—
SC
05
—
PG1066
—
SC
Enumeration date
04/19/2007
Last updated
08/02/2022
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