Edward L Proctor Jr, MD | |
923 Medical Cir, Myrtle Beach, SC 29572-4116 | |
(843) 503-5442 | |
(843) 449-6213 |
Full Name | Edward L Proctor Jr |
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Gender | Male |
Speciality | Pathology - Anatomic Pathology & Clinical Pathology |
Location | 923 Medical Cir, Myrtle Beach, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1316917362 | NPI | - | NPPES |
890659V | Medicaid | NC | |
103033 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207ZF0201X | Pathology - Forensic Pathology | 10303 (South Carolina) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 10303 (South Carolina) | Primary |
Entity Name | Strand Gi Associates Pa |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700864519 PECOS PAC ID: 2163413717 Enrollment ID: O20040521000433 |
Mailing Address | Practice Location Address |
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Edward L Proctor Jr, MD 923 Medical Cir, Myrtle Beach, SC 29572-4116 Ph: (843) 503-5442 | Edward L Proctor Jr, MD 923 Medical Cir, Myrtle Beach, SC 29572-4116 Ph: (843) 503-5442 |
Charles T Walls Jr., MD Pathology Medicare: Medicare Enrolled Practice Location: 915 Medical Cir, Myrtle Beach, SC 29572 Phone: 843-213-1790 Fax: 843-213-1830 | |
Dr. Brian Wesley Watson, M.D. Pathology Medicare: Accepting Medicare Assignments Practice Location: 809 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-692-1495 Fax: 843-449-6213 | |
Dr. Stephen Hammond, M.D Pathology Medicare: Accepting Medicare Assignments Practice Location: 8170 Rourk St Ste 100, Myrtle Beach, SC 29572 Phone: 843-282-1915 | |
Caleb Vanguilder Scott, Pathology Medicare: Accepting Medicare Assignments Practice Location: 809 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-692-1000 |