| NPI | 1235552746 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDMOND RUSSELL BAXLEY CEO 843-522-5140 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology (Licence: SC 36465) |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2020-06-18 |