| NPI | 1336627371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY D. CHILDS CEO 843-747-2273 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC 18613) |
| Additional Taxonomies | 207RI0200X Internal Medicine, Infectious Disease (Licence: SC 18613) |
| Enumeration Date | 2018-08-01 |
| Last Update Date | 2023-09-19 |