| NPI | 1962691402 |
|---|---|
| Doing Business As | WACCAMAW FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | SUE R. STARK Co Administrator 843-527-4442 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2007-10-22 |
| Last Update Date | 2010-11-03 |