| Antoinette Marie Bannister, MD | |
| 450 Old Greenville Hwy, Clemson, SC 29631-1670 | |
| (864) 653-8964 | |
| Not Available | 
| Full Name | Antoinette Marie Bannister | 
|---|---|
| Gender | Female | 
| Speciality | Pediatrics | 
| Location | 450 Old Greenville Hwy, Clemson, 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 | 
|---|---|---|---|
| 1174579254 | NPI | - | NPPES | 
| 367640 | Medicaid | SC | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 208000000X | Pediatrics | 36764 (South Carolina) | Primary | 
| Entity Name | Prisma Health University Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1295763217 PECOS PAC ID: 8325950983 Enrollment ID: O20031103000238 | 
| Entity Name | Prisma Health University Medical Group | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1568799955 PECOS PAC ID: 8325950983 Enrollment ID: O20040108000041 | 
| Mailing Address | Practice Location Address | 
|---|---|
| Antoinette Marie Bannister, MD 300 E Mcbee Ave Fl 4, Greenville, SC 29601-2842 Ph: (864) 522-8611 | Antoinette Marie Bannister, MD 450 Old Greenville Hwy, Clemson, SC 29631-1670 Ph: (864) 653-8964 | 
| Marion A Wills, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 450 Old Greenville Hwy, Clemson, SC 29631 Phone: 864-653-8964 Fax: 846-653-8963 | |
| Prasiksha Sitaula, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 885 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-5725 Fax: 864-512-8039 | |
| James E Feiste, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 885 Tiger Blvd, Clemson, SC 29631 Phone: 864-512-5890 Fax: 864-512-4711 | |
| Elizabeth Anton Chea, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 208 Frontage Rd, Suite 1, Clemson, SC 29631 Phone: 864-654-6034 |