NPI | 1649915216 |
---|---|
Entity Type | Organization |
Authorized Contact | DAVID 'CARSON' MOORE Owner/Authorized Official 843-324-7575 |
Organization Subpart ? | No |
Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine |
208000000X Pediatrics | |
2080A0000X Pediatrics, Adolescent Medicine | |
Enumeration Date | 2022-04-28 |
Last Update Date | 2023-01-30 |