Healthcare Provider Details

I. General information

NPI: 1538198080
Provider Name (Legal Business Name): MEENAKSHI A PANDE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1204 E CHEVES ST
FLORENCE SC
29506-2710
US

IV. Provider business mailing address

1204 E CHEVES ST
FLORENCE SC
29506-2710
US

V. Phone/Fax

Practice location:
  • Phone: 843-673-0122
  • Fax: 843-661-6400
Mailing address:
  • Phone: 843-673-0122
  • Fax: 843-661-6400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number26633
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: