| NPI | 1659912079 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIE PRICE Manager 843-608-6999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2019-10-07 |
| Last Update Date | 2019-10-07 |