| Aka E C Medical Specialist | |
|
997 Hwy 17 Business South Suite C Surfside Beach SC 29575-6084 | |
| (843) 839-4505 | |
| (843) 839-2851 |
| Full Name | Aka E C Medical Specialist |
|---|---|
| Speciality | Internal Medicine |
| Location | 997 Hwy 17 Business South, Surfside Beach, South Carolina |
| Authorized Official Name and Position | Janet Faye Buchanan (OFFICE MANAGER) |
| Authorized Official Contact | 8438394505 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Aka E C Medical Specialist 4701 Oleander Drive Suite B Myrtle Beach SC 29577 Ph: (843) 497-6301 | Aka E C Medical Specialist 997 Hwy 17 Business South Suite C Surfside Beach SC 29575-6084 Ph: (843) 839-4505 |
| NPI Number | 1558575217 |
|---|---|
| Provider Enumeration Date | 05/10/2007 |
| Last Update Date | 11/26/2008 |
| Medicare PECOS PAC ID | 5092740449 |
|---|---|
| Medicare Enrollment ID | O20051004000931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558575217 | NPI | - | NPPES |
| GP0772 | Medicaid | SC | |
| 1558345686 | Other | SC | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | 15450 (South Carolina) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 15451 (South Carolina) | Primary |
| Provider Name | John E Rathbun |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558345686 PECOS PAC ID: 3779518121 Enrollment ID: I20120216000355 |
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