| NPI | 1518143221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK T GOULAS Partner 843-757-9661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207W00000X Ophthalmology (Licence: SC 22573) |
| Additional Taxonomies | 207W00000X Ophthalmology (Licence: SC 26698) |
| 207W00000X Ophthalmology (Licence: SC 1335) | |
| 207W00000X Ophthalmology (Licence: SC 1344) | |
| 208200000X Plastic Surgery (Licence: SC 22573) | |
| Enumeration Date | 2008-01-11 |
| Last Update Date | 2008-01-11 |