Ballentine Pediatrics, Llc
Pediatric Adolescent Medicine
Ballentine Pediatrics, Llc is a Irmo, South Carolina based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
11134 Broad River Rd, Suite D, Irmo, South Carolina - 29063-9668. They can be contacted on phone at
803-732-0920 and fax number 803-227-2759.
NPI number (Unique professional ID) for Ballentine Pediatrics, Llc is
1629234141 which was assigned by NPPES on 04 Aug, 2008 and it was last updated on 04 Aug, 2008.
Ballentine Pediatrics, Llc license number is
19500 for Pediatrics Adolescent Medicine (2080A0000X) in South Carolina.
Ballentine Pediatrics, Llc specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Ballentine Pediatrics, Llc basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
|---|
| Provider Name : | Ballentine Pediatrics, Llc |
|---|
Business Address:
Ballentine Pediatrics, Llc address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 11134 Broad River Rd, Suite D
Irmo, SC, 29063-9668
United States |
|---|
| Phone Number : | 803-732-0920 |
|---|
| Fax Number : | 803-227-2759 |
|---|
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1629234141 |
|---|
| NPI Entity Type : | Organization |
|---|
| First Enrolment Date : | 04 Aug, 2008 |
|---|
| Last Updated On : | 04 Aug, 2008 |
|---|
Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Deannenicola Geurkink |
|---|
| Authorized Official Credential : | MD |
|---|
| Official Title or Position : | OWNER/PROVIDER |
|---|
| Phone Number : | 803-732-0920 |
|---|
Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Ballentine Pediatrics, Llc are as mentioned. Primary taxonomy code for Ballentine Pediatrics, Llc is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 19500 | SC |
Legacy Identifiers:
Other legacy medical identifiers of Ballentine Pediatrics, Llc such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| 195005 | MEDICAID | SC | |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 11134 Broad River Rd, Suite D
Irmo, SC, 29063-9668
United States |
|---|
| Phone Number : | 803-732-0920 |
|---|
| Fax Number : | 803-227-2759 |
|---|
Business Location:
Patients can refer following map for directions to
Ballentine Pediatrics, Llc practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.