| Tidelands Health Family Medicine | |
|
12117 Ocean Hwy Pawleys Island SC 29585 | |
| (843) 237-8231 | |
| (843) 237-8551 |
| Full Name | Tidelands Health Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 12117 Ocean Hwy, Pawleys Island, South Carolina |
| Authorized Official Name and Position | Elizabeth Sutherland Ward (EVP & CFO) |
| Authorized Official Contact | 8435277102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidelands Health Family Medicine Po Box 421718 Georgetown SC 29442-4203 Ph: (843) 520-8883 | Tidelands Health Family Medicine 12117 Ocean Hwy Pawleys Island SC 29585 Ph: (843) 237-8231 |
| NPI Number | 1811233562 |
|---|---|
| Provider Enumeration Date | 12/28/2012 |
| Last Update Date | 06/25/2020 |
| Certification Date | 06/25/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811233562 | NPI | - | NPPES |
| GP6125 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101Y00000X | Counselor | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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