| NPI | 1497062384 |
|---|---|
| Doing Business As | WACCAMAW FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | SUE STARK Coadministrator 843-543-0090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2010-09-13 |
| Last Update Date | 2010-09-13 |