| NPI | 1689360307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA BROWN Hr Manager 843-839-4447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 2085U0001X Radiology Diagnostic Ultrasound |
| 2471C3401X Radiologic Technologist Computed Tomography | |
| 291U00000X Clinical Medical Laboratory | |
| 363A00000X Physician Assistant | |
| 207R00000X Internal Medicine | |
| 363AM0700X Physician Assistant Medical | |
| 363L00000X Nurse Practitioner | |
| 363LF0000X Nurse Practitioner Family | |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-09-18 |