| NPI | 1184213316 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIAN J STOKES Nurse Practitioner 843-773-2289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care |
| Enumeration Date | 2021-01-12 |
| Last Update Date | 2021-02-14 |