Healthcare Provider Details

I. General information

NPI: 1598708232
Provider Name (Legal Business Name): CATHERINE PARTYKA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 06/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9330 MEDICAL PLAZA DR. TRIDENT MEDICAL CENTER
CHARLESTON SC
29406
US

IV. Provider business mailing address

9330 MEDICAL PLAZA DR. TRIDENT MEDICAL CENTER
CHARLESTON SC
29406
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-7000
  • Fax:
Mailing address:
  • Phone: 843-797-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberD0052144
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: