Organization
W PETTIGREW CLARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM PETTIGREW CLARE MD (OWNER)
(843) 762-3550
Entity
Organization
Contact information
Practice address
1155 FORT LAMAR RD, CHARLESTON, SC 29412-9683
(843) 762-3550
(843) 795-8945
Mailing address
1155 FORT LAMAR RD, CHARLESTON, SC 29412-9683
(843) 762-3550
(843) 795-8945
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5058
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57-051956
TAX IDENTIFICATION
SC
Enumeration date
03/16/2007
Last updated
08/22/2020
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