Organization
THE PEDIATRIC CLINIC, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PEGGY C. THOMAS (OFFICE MANAGER)
(803) 536-2725
Entity
Organization
Contact information
Practice address
940 HOLLY ST NE, ORANGEBURG, SC 29115-4930
(803) 536-2725
(803) 534-1441
Mailing address
940 HOLLY ST NE, ORANGEBURG, SC 29115-4930
(803) 536-2725
(803) 534-1441
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0966
—
SC
Enumeration date
07/11/2005
Last updated
07/21/2022
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