| NPI | 1114780483 |
|---|---|
| Doing Business As | TIDELANDS HEALTH UROLOGY |
| Entity Type | Organization |
| Authorized Contact | ELIZABETH SUTHERLAND WARD Chief Financial Officer 843-527-7102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology |
| Enumeration Date | 2024-01-31 |
| Last Update Date | 2024-03-25 |