| Christine Canivan, MD | |
|
5000 Epson Plantation Dr Ste B, Moncks Corner, SC 29461-3979 | |
| (843) 792-1414 | |
| Not Available |
| Full Name | Christine Canivan |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 5000 Epson Plantation Dr Ste B, Moncks Corner, 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 |
|---|---|---|---|
| 1427067818 | NPI | - | NPPES |
| 205860 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 20586 (South Carolina) | Primary |
| Entity Name | University Medical Associates Of The Medical University Of South Carol |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043241110 PECOS PAC ID: 6305758574 Enrollment ID: O20031105000291 |
| Entity Name | Carolina Family Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1184655722 PECOS PAC ID: 4587557731 Enrollment ID: O20040203000627 |
| Mailing Address | Practice Location Address |
|---|---|
| Christine Canivan, MD Po Box 602108, Charlotte, NC 28260-2108 Ph: (843) 792-6200 | Christine Canivan, MD 5000 Epson Plantation Dr Ste B, Moncks Corner, SC 29461-3979 Ph: (843) 792-1414 |
Dr. Joseph Carlisle Moore Jr., M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 730 Stoney Landing Rd, Suite 200, Moncks Corner, SC 29461 Phone: 843-761-2000 Fax: 843-761-1388 | |
Edward Johnson Jones Iii, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 115 Executive Parkway, Moncks Corner, SC 29461 Phone: 843-761-2815 Fax: 843-869-8034 |