Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Other names
Edisto Regional Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS DANDRIDGE (PRESIDENT)
(803) 395-2200
Entity
Organization
Contact information
Practice address
2850 PELHAM CT, ORANGEBURG, SC 29118-1400
(803) 531-8500
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4499
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4354
—
SC
Enumeration date
05/26/2006
Last updated
08/22/2020
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