| NPI | 1962767756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH S. BREDESTEGE Owner 843-851-3800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology |
| Additional Taxonomies | 207VX0000X Obstetrics & Gynecology Obstetrics |
| Enumeration Date | 2012-07-09 |
| Last Update Date | 2012-07-09 |