NPI | 1932376118 |
---|---|
Entity Type | Organization |
Authorized Contact | DEBRA P MATTHEWS Office Manager 843-664-8882 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: SC MD10962) |
Enumeration Date | 2008-05-15 |
Last Update Date | 2008-05-15 |