Chesterfield Clinic Corp
Organization Active NPI Family Medicine Physician · Cheraw, SC
NPI 1013986405 · NPPES record last updated Sep 24, 2007
Key facts
- NPI
- 1013986405
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CHESTERFIELD CLINIC CORP
- Practice address
- 715 S Doctors Dr
Suite B
Cheraw, SC 29520-7113 - Phone
- (843) 537-6557
- NPI assigned
- Mar 16, 2006
- Organization subpart
- Yes
- Parent organization (as reported)
- CHESTERFIELD CLINIC CORP
Authorized official
- Name
- Debbie Brewer
- Title
- Director of Provider Enrollment
- Phone
- (615) 465-7626
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- CHS Chesterfield Emp
- Part of
- CHS Chesterfield Emp
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
715 S Doctors Dr
Suite B
Cheraw, SC 29520-7113
Mailing address
715 S Doctors Dr
Suite B
Cheraw, SC 29520-7113
Phone (843) 537-6557
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GP4513 | Medicaid | SC |
Other names
- Hometown Family Care
Other providers in Cheraw, SC
- Cheraw Healthcare Inc
- Cheraw Pediatrics, P.a.
- Cheraw Physical Therapy & Rehabilitation Center LLC.
- Cheraw Physicians Group LLC
- Martin Luther Sherley Cherenfant
- Chesterfield Clinic Corp
- Chesterfield Clinic Corp
- Chesterfield Clinic Corp
- Chesterfield Clinic Corp
- Chesterfield Clinic Corp
All providers in Cheraw, SC · Family Medicine Physician in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.