| NPI | 1205693991 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL FULTON ERVIN Sr VP & CFO 843-777-2910 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2080P0205X Pediatrics Pediatric Endocrinology |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2024-02-29 |
| Last Update Date | 2024-02-29 |