| NPI | 1932870318 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA HURLEY Practice Administrator 843-200-7721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2021-09-24 |
| Last Update Date | 2021-09-24 |