Anna C Pruitt, MD | |
3800 Faber Place Dr, North Charleston, SC 29405 | |
(843) 747-4647 | |
(843) 745-0969 |
Full Name | Anna C Pruitt |
---|---|
Gender | Female |
Speciality | Pediatrics |
Location | 3800 Faber Place Dr, North Charleston, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1023057676 | NPI | - | NPPES |
571020809034 | Other | SC | TRICARE |
196264 | Medicaid | SC | |
571020809002 | Other | SC | BCBS SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 19626 (South Carolina) | Primary |
Entity Name | Liberty Doctors Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700162203 PECOS PAC ID: 0840466017 Enrollment ID: O20120110000683 |
Mailing Address | Practice Location Address |
---|---|
Anna C Pruitt, MD Po Box 751649, Charlotte, NC 28275-1649 Ph: (843) 789-1620 | Anna C Pruitt, MD 3800 Faber Place Dr, North Charleston, SC 29405 Ph: (843) 747-4647 |
Danielle Davis Decourcey, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 4975 Lacross Road Suite 150, North Charleston, SC 29406 Phone: 843-737-9467 | |
Dr. Sumita Kumari Debroy, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2713 Dantzler Dr, North Charleston, SC 29406 Phone: 843-764-1722 Fax: 843-764-1788 | |
Dr. Jordan Stuart Whatley, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 2250 Mall Dr, North Charleston, SC 29406 Phone: 843-876-0444 Fax: 310-206-0203 | |
Casey Harvey King, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 2713 Dantzler Dr, North Charleston, SC 29406 Phone: 843-764-1722 Fax: 843-764-1788 | |
Dr. Farrow Counts Durant, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2713 Dantzler Dr, North Charleston, SC 29406 Phone: 843-764-1722 Fax: 843-764-1788 | |
Carol K Klauber, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 3800 Faber Place Dr, North Charleston, SC 29405 Phone: 843-747-4647 Fax: 843-745-0969 |