| NPI | 1861871220 |
|---|---|
| Doing Business As | MCLEOD PEDIATRICS BENNETTSVILLE |
| Entity Type | Organization |
| Authorized Contact | DANE P. FICCO Senior Vice President 843-777-7010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics |
| Enumeration Date | 2015-05-19 |
| Last Update Date | 2015-05-19 |