| NPI | 1104899145 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH D. BEASLEY Senior Vice President 843-777-7010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) |
| Additional Taxonomies | 363AS0400X Physician Assistant Surgical |
| 2086S0129X Surgery Vascular Surgery | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2022-06-03 |