| NPI | 1780995373 |
|---|---|
| Other Name | CPG FAMILY MEDICINE BELL STREET |
| Former Legal Business Name | CONWAY HOSPITAL COMMUNITY SERVICES |
| Doing Business As | CMC PRIMARY CARE-BELL STREET |
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN ARTIOLI Credentialing Specialist 843-234-6946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2010-06-29 |
| Last Update Date | 2020-08-20 |