Organization
PALMETTO PEDIATRICS OF CONWAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN M RABON MD (MD)
(843) 234-5678
Entity
Organization
Contact information
Practice address
171 WACCAMAW MEDICAL PARK CT, CONWAY, SC 29526-8965
(843) 234-5678
(843) 234-4567
Mailing address
171 WACCAMAW MEDICAL PARK CT, CONWAY, SC 29526-8965
(843) 234-5678
(843) 234-4567
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22576
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4121
—
SC
Enumeration date
01/12/2006
Last updated
01/27/2011
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