Healthcare Provider Details

I. General information

NPI: 1215991757
Provider Name (Legal Business Name): ELLEN PATRICE TURBEVILLE MINTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: PATRICE T. MINTER MD

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST
LAKE CITY SC
29560-4400
US

IV. Provider business mailing address

1221 VIA PONTICELLO
FLORENCE SC
29501-6254
US

V. Phone/Fax

Practice location:
  • Phone: 843-977-7337
  • Fax: 843-956-5415
Mailing address:
  • Phone: 843-977-7337
  • Fax: 843-977-7337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20790
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: