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MIDLANDS PEDIATRICS PA NPI 1356403612


NPI Information

NPI: 1356403612
Provider Name: MIDLANDS PEDIATRICS PA
Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
2712 MIDDLEBURG DRIVE
SUITE #101
COLUMBIA, SC
ZIP 29204
Phone: (803) 254-4257
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MIDLANDS PEDIATRICS PA is a pediatrics in Columbia, SC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. MIDLANDS PEDIATRICS PA NPI is 1356403612. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2712 MIDDLEBURG DRIVE
SUITE #101
COLUMBIA, SC
ZIP 29204-415
Phone: (803) 254-4257
Fax: (803) 252-7334

The provider's authorized official is Clarence Joseph Dollison .
The authorized official title is President and has the following contact phone number (803) 254-4257.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 9/23/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP 3475MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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