| NPI | 1619226842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHYRL IVEY Owner 843-606-2530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2012-09-04 |
| Last Update Date | 2012-09-04 |