| NPI | 1114416799 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM D. ANDERSON III, Chief Medical Officer 803-545-5005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2080C0008X Pediatrics, Child Abuse Pediatrics |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2018-05-09 |
| Last Update Date | 2018-05-09 |