| NPI | 1821205097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL C BREWER Owner 843-524-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: SC 17632) |
| Additional Taxonomies | 207NP0225X Dermatology Pediatric Dermatology (Licence: SC 17636) |
| Enumeration Date | 2007-05-17 |
| Last Update Date | 2007-10-09 |