Mr Mark D Chanaca, PT | |
2200 Crow Ln, Myrtle Beach, SC 29577-1663 | |
(843) 848-5000 | |
Not Available |
Full Name | Mr Mark D Chanaca |
---|---|
Gender | Male |
Speciality | Physical Therapy |
Experience | 24 Years |
Location | 2200 Crow Ln, Myrtle Beach, South Carolina |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1346290939 | NPI | - | NPPES |
TH1418 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | 4652 (South Carolina) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Georgetown Physician Associates, Llc | 2365697398 | 171 |
Provider Name | Georgetown Physician Associates, Llc |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1235475930 PECOS PAC ID: 2365697398 Enrollment ID: O20130225000067 |
Mailing Address | Practice Location Address |
---|---|
Mr Mark D Chanaca, PT Po Box 421718, Georgetown, SC 29442-4203 Ph: (843) 652-8226 | Mr Mark D Chanaca, PT 2200 Crow Ln, Myrtle Beach, SC 29577-1663 Ph: (843) 848-5000 |
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