Caromont Medical Group INC
Pediatrics in Clover, SC. Organization (NPI-2).
NPI number1174200315
StatusActive
Last updated in NPPESAug 18, 2026
Details
- NPI
- 1174200315
- Entity type
- Organization (NPI-2)
- Legal business name
- Caromont Medical Group INC
- Organization subpart
- Yes
- Enumeration date
- Jun 29, 2023
- Certification date
- Aug 18, 2026
- Last updated
- Aug 18, 2026
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | – | – | Yes |
Other names
- Caromont Pediatric Partners (Doing Business As)
Practice location
519 Nautical DrSuite 100b
Clover, SC 29710-8113
Phone 803-831-2796 · Fax 803-831-8614
Mailing address
Po Box 744786Atlanta, GA 30374-4786
Phone 704-834-2450 · Fax 704-671-5331
Authorized official
David Michael Oconnor
Cfo
7046715343
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