| NPI | 1629041009 |
|---|---|
| Doing Business As | MCLEOD FAMILY MEDICINE - HEALTH AND FITNESS |
| Entity Type | Organization |
| Authorized Contact | KENNETH D. BEASLEY Senior Vice President 843-777-7010 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2006-02-08 |
| Last Update Date | 2022-06-07 |