| Organization Name: | MPPG, INC. |
| NPI Number: | 1609170901 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ROBIN J. MADDOX (PROVIDER ENROLLMENT COORDINATOR) |
| Mailing Address: | 14 Okatie Center Blvd. South Suite 101 Okatie |
| State: | SC US |
| Postal Code: | 29909 |
| Phone Number: | 9123508180 |
| Fax Number: | 9123508427 |
| NPI Enumeration Date: | 12/29/2010 |
| NPI Last Update Date: | 06/01/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080P0207X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Pediatric Hematology-Oncology |
| Taxonomy Definition: | A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |