Campbell, Penelope Anne
Campbell, Penelope Anne is an individual health care provider with primary practice located at 4022 Postal Way Ste C , Myrtle Beach SC 29579-3537. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Campbell, Penelope Anne can be contacted via phone (843) 903-4111.Contact Information
Primary practice address
4022 Postal Way Ste C
Myrtle Beach SC 29579-3537
Phone: (843) 903-4111
Fax: (843) 903-4242
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 2080A0000X | 27349 | South Carolina |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 27349 | South Carolina |
Profile Details
| NPI number | 1124084876 |
|---|---|
| LBN Legal business name | Campbell, Penelope Anne |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 21st, 2006 |
| Last updated | Feb 2nd, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124084876 | NPPES |
| South Carolina | Other | 7844 | MEDICARE PTAN |
| South Carolina | Other | 570783896 | MEDICARE PTAN |
| South Carolina | MEDICAID | GP4505 | MEDICARE PTAN |
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