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:
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Health care specialties

SpecialtyCodeLicense #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 12 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.

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Identifiers

StateTypeNumberIssuer
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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