Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080A0000X | Adolescent Medicine | 14952 | MS |
Y | 2080A0000X | Adolescent Medicine | 82320 | SC |
NPI | 1114965936 |
---|---|
Provider Name | Dr. Christine K Chard |
First Address | Clinton, SC 29325-7532 |
Second Address | Clinton, SC 29325-7532 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 09/01/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00121295 | (05) | MS |
823201 | (05) | SC |