| Marian Mitchell Oliver Corporation | |
|
939 John C. Calhoun Drive Orangeburg SC 29115 | |
| (803) 531-0021 | |
| Not Available |
| Full Name | Marian Mitchell Oliver Corporation |
|---|---|
| Speciality | Dentist |
| Location | 939 John C. Calhoun Drive, Orangeburg, South Carolina |
| Authorized Official Name and Position | Dwight Delano Mcmillan (PRESIDENT) |
| Authorized Official Contact | 8035310021 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Marian Mitchell Oliver Corporation 939 John C. Calhoun Drive Orangeburg SC 29115 Ph: (803) 531-0021 | Marian Mitchell Oliver Corporation 939 John C. Calhoun Drive Orangeburg SC 29115 Ph: (803) 531-0021 |
| NPI Number | 1972553881 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 11/12/2023 |
| Medicare PECOS PAC ID | 8729223300 |
|---|---|
| Medicare Enrollment ID | O20130402000448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972553881 | NPI | - | NPPES |
| ZA9906 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3333 (South Carolina) | Primary |
| Provider Name | Dwight D Mcmillan |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1932130606 PECOS PAC ID: 9537304118 Enrollment ID: I20130402000463 |
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