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1750577391
TIDEWATER INTERNAL MEDICINE II LLC
CHARLESTON, SC
NPI
1750577391
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Entity Type
Organization
Authorized Contact
ALICIA HOLDEN
Lead
404-943-0205
Organization Subpart ?
No
Primary Taxonomy
261QP2300X Clinic/Center, Primary Care
Enumeration Date
2007-09-18
Last Update Date
2007-09-18
Business Address
TIDEWATER INTERNAL MEDICINE II LLC
2097 HENRY TECKLENBURG DR SUITE 301
CHARLESTON, SC 29414-5740
Phone number: 404-943-0205
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Mailing Address
TIDEWATER INTERNAL MEDICINE II LLC
PO BOX 468329
ATLANTA, GA 31146-8329
Phone number:
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