| NPI | 1730810359 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KARYN RAE Chief, Payor Relations And Reimburs 843-876-1344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2022-06-23 |
| Last Update Date | 2022-09-13 |