| NPI | 1649773789 |
|---|---|
| Doing Business As | TIDEWATER HEALTH |
| Entity Type | Organization |
| Authorized Contact | DAVID L SMITH President 843-800-5686 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2019-05-01 |