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701 S Morgan Ave Andrews SC 29510-2959 | |
(843) 264-5253 | |
Not Available |
Full Name | |
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Speciality | Family Medicine |
Location | 701 S Morgan Ave, Andrews, South Carolina |
Authorized Official Name and Position | Sue R. Stark (CO-ADMINISTRATOR) |
Authorized Official Contact | 8435274442 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1075 N Fraser St Georgetown SC 29440-2848 Ph: (843) 527-4442 | 701 S Morgan Ave Andrews SC 29510-2959 Ph: (843) 264-5253 |
NPI Number | 1144401365 |
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Provider Enumeration Date | 11/15/2007 |
Last Update Date | 11/19/2007 |
Identifier | Type | State | Issuer |
---|---|---|---|
1144401365 | NPI | - | NPPES |
GP1366 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Primary |