Pauline Mary Anderson, MD
Individual provider Active NPI Obstetrics & Gynecology Physician · Manning, SC
NPI 1174592471 · NPPES record last updated Oct 27, 2016
Key facts
- NPI
- 1174592471
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 12814 (SC)
- Practice address
- 50 E Hospital St
Suite 4a
Manning, SC 29102-3149 - Phone
- (803) 433-0797
- Fax
- (803) 433-0896
- NPI assigned
- Mar 17, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12814 | SC | MD | Obstetrics & Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tuomey Medical Professionals, Inc | Obstetrics & Gynecology | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 12814 | SC | Yes |
Addresses
Primary practice location
50 E Hospital St
Suite 4a
Manning, SC 29102-3149
Mailing address
PO Box 3239
Florence, SC 29502-3239
Phone (803) 435-5270
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 128141 | Medicaid | SC |
Other providers in Manning, SC
- Heather Alsbrook
- Casey R. Amato
- Americare Medical Services LLC
- Anderson Pharmacy
- Jeffrey Stephen Anderson
- Sharmane Yvonne Anderson
- Atc Home Care Service
- Druid Carlisle Atwell
- B & H Consultants LLC
- Chris Bachochin
All providers in Manning, SC · Obstetrics & Gynecology 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 Oct 27, 2016. 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.