| Dr Ugochi Cantave, MD | |
|
1875 N Paris Ave, Port Royal, SC 29935-2029 | |
| (843) 522-3870 | |
| (843) 522-0691 |
| Full Name | Dr Ugochi Cantave |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1875 N Paris Ave, Port Royal, 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 |
|---|---|---|---|
| 1720219256 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | TL32111 (South Carolina) | Primary |
| Entity Name | Eau Claire Cooperative Health Center, Inc. |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1346249430 PECOS PAC ID: 3274434220 Enrollment ID: O20040114000335 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Ugochi Cantave, MD 1875 N Paris Ave, Port Royal, SC 29935-2029 Ph: (843) 522-3870 | Dr Ugochi Cantave, MD 1875 N Paris Ave, Port Royal, SC 29935-2029 Ph: (843) 522-3870 |
Faith Lawrence Polkey, M.D., M.P.H. Pediatrics Medicare: Medicare Enrolled Practice Location: 1320 Ribaut Rd, Port Royal, SC 29935 Phone: 843-986-0900 Fax: 843-322-1875 | |
Marlo Monique Smith, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1320 Ribaut Rd, Port Royal, SC 29935 Phone: 843-986-0900 Fax: 843-322-1875 | |
John Bruce Etheridge, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1320 Ribaut Rd, Port Royal, SC 29935 Phone: 843-986-0900 |