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NPI Code Detail

MEDICARE: SWEETGRASS PEDIATRICS

MEDICARE: SWEETGRASS PEDIATRICS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
220014778OTHERSCSELECT HEALTH OF SC

General Provider Information

NPI Number : 1437168135
Entity Type Code : Organization
Provider Name (Legal Business Name) : SWEETGRASS PEDIATRICS
Provider Business Mailing Address
First Line : 2713 DANTZLER DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9005
Country : US
Telephone Number : 843-764-1722
Fax Number : 843-764-1788
Provider Business Practice Location Address
First Line : 2713 DANTZLER DR
Second Line :
City : NORTH CHARLESTON
State : SC
Zip : 29406-9005
Country : US
Telephone Number : 843-764-1722
Fax Number : 843-764-1788
Authorized Official
Title or Position : OFFICE MANAGER
Name : MRS. LAURA HILTON JAMES
Credential :
Telephone Number : 843-764-1722
Provider Enumeration Date : 08/05/2006
Last Update Date : 08/22/2020

Similar Medicare Providers

1821109323 — DR. LISA BRYCE LOPEZ MD
Practice Location Address:
2713 DANTZLER DR
NORTH CHARLESTON, SC
29406-9005
Practice Phone: 843-764-1722
Practice Fax: 843-764-1788
1770440646 — TRACIE LEIGH LAMB
Practice Location Address:
2713 DANTZLER DR
NORTH CHARLESTON, SC
29406-9005
Practice Phone: 843-764-1722
Practice Fax:
1447250378 — DR. AMY REBMAN DIETRICH MD
Practice Location Address:
2713 DANTZLER DR
NORTH CHARLESTON, SC
29406-9005
Practice Phone: 843-764-1722
Practice Fax: 843-764-1788
1700818358 — MRS. JENNIFER ADELE MEYER MD
Practice Location Address:
2713 DANTZLER DR
NORTH CHARLESTON, SC
29406-9005
Practice Phone: 843-764-1722
Practice Fax: 813-764-1788
1740299189 — DR. COLLEEN JANE BOYLSTON MD
Practice Location Address:
2713 DANTZLER DR
CHARLESTON, SC
29406-9005
Practice Phone: 843-764-1722
Practice Fax: 843-764-1788
1164538732 — DR. SUMITA KUMARI DEBROY MD
Practice Location Address:
2713 DANTZLER DR
NORTH CHARLESTON, SC
29406-9005
Practice Phone: 843-764-1722
Practice Fax: 843-764-1788

Directions to “SWEETGRASS PEDIATRICS ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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