Healthcare Provider Details
I. General information
NPI: 1598630931
Provider Name (Legal Business Name): TOTALITY PEDIATRICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/07/2025
Last Update Date: 10/07/2025
Certification Date: 09/21/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1026 B POWDERSVILLE RD
EASLEY SC
29642-0900
US
IV. Provider business mailing address
501 SUNSET DR
MANNING SC
29102-2208
US
V. Phone/Fax
- Phone: 843-814-8249
- Fax:
- Phone: 843-814-8249
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | |
| License Number State | |
VII. Legacy identifiers
For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:
VIII. Authorized Official
Name: DR.
MOHAMMED
M
AL GADBAN
Title or Position: OWNER
Credential: MD
Phone: 843-814-8249