| |
860 Parris Island Gtwy, Suite B-2, Beaufort, SC 29906-6921 | |
(843) 986-9292 | |
(843) 524-9294 |
Full Name | |
---|---|
Type | Facility |
Speciality | Surgery |
Location | 860 Parris Island Gtwy, Beaufort, South Carolina |
Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770552408 | NPI | - | NPPES |
GCH517 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
111N00000X | Chiropractor | 2493 (South Carolina) | Secondary |
207Y00000X | Otolaryngology | 11027 (South Carolina) | Secondary |
208600000X | Surgery | 11027 (South Carolina) | Primary |
Mailing Address | Practice Location Address |
---|---|
860 Parris Island Gtwy, Suite B2, Beaufort, SC 29906-6921 Ph: (843) 986-9292 | 860 Parris Island Gtwy, Suite B-2, Beaufort, SC 29906-6921 Ph: (843) 986-9292 |