| NPI | 1265502744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA M MITCHUM Office Manager 843-851-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: SC 10650BG) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology, Obstetrics (Licence: SC 10650BG) |
| Enumeration Date | 2006-11-09 |
| Last Update Date | 2007-07-11 |