Organization
CLEMSON/SENECA PEDIATRICS AND ADOLESCENT MEDICINE, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LISA CRANE C.N.A. (INSURANCE MANAGER)
(864) 888-4222
Entity
Organization
Contact information
Practice address
207 MAIN ST, SENECA, SC 29678-3245
(864) 888-4222
(864) 888-0023
Mailing address
207 MAIN ST, SENECA, SC 29678-3245
(864) 888-4222
(864) 888-0023
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
10252
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHC115
—
SC
Enumeration date
08/11/2005
Last updated
08/22/2020
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