Organization
PRISMA HEALTH UNIVERSITY MEDICAL GROUP
Active
Other names
Eastside Pediatrics, PA
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTI ANN LAWRENCE (DIRECTOR)
(864) 522-8611
Entity
Organization
Contact information
Practice address
4501 OLD SPARTANBURG RD STE 9, TAYLORS, SC 29687-4105
(864) 292-8868
(864) 268-9564
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0576
—
SC
Enumeration date
08/11/2022
Last updated
08/29/2022
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