| NPI | 1053967943 |
|---|---|
| Doing Business As | TIDELANDS HEALTH PEDIATRICS |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SUTHERLAND WARD EVP & CFO 843-527-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2020-05-01 |