| NPI | 1821317363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY MARIE BARTLOW Billing 843-684-5501 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology (Licence: SC 30791) |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics (Licence: SC 30791) |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2010-05-24 |