Healthcare Provider Details

I. General information

NPI: 1134445398
Provider Name (Legal Business Name): CALLIE COOK BARNWELL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CALLIE COOK M.D.

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 02/24/2020
Certification Date: 02/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 MEDICAL RIDGE DR
GREENVILLE SC
29605-4267
US

IV. Provider business mailing address

1 INDEPENDENCE PT STE 212
GREENVILLE SC
29615-4536
US

V. Phone/Fax

Practice location:
  • Phone: 864-722-0727
  • Fax:
Mailing address:
  • Phone: 864-797-6015
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number37284
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: