| Family Medicine Of Sayebrook | |
|
106 Lansford Ct. Suite 100 Myrtle Beach SC 29588-6979 | |
| (843) 293-8850 | |
| Not Available |
| Full Name | Family Medicine Of Sayebrook |
|---|---|
| Speciality | Family Medicine |
| Location | 106 Lansford Ct., Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Lisa M Garozzo (OFFICE MANAGER) |
| Authorized Official Contact | 8432938850 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medicine Of Sayebrook 106 Lansford Ct. Suite 100 Myrtle Beach SC 29588-6979 Ph: (843) 293-8850 | Family Medicine Of Sayebrook 106 Lansford Ct. Suite 100 Myrtle Beach SC 29588-6979 Ph: (843) 293-8850 |
| NPI Number | 1093887234 |
|---|---|
| Provider Enumeration Date | 11/14/2006 |
| Last Update Date | 09/02/2016 |
| Medicare PECOS PAC ID | 4789685256 |
|---|---|
| Medicare Enrollment ID | O20070125000458 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093887234 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Jonathan D Bornfreund |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689634289 PECOS PAC ID: 2668377805 Enrollment ID: I20031202000094 |
| Provider Name | Karen L Mahood |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1780644971 PECOS PAC ID: 9830179522 Enrollment ID: I20040722001194 |
| Provider Name | Edward R Mccarthy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295795920 PECOS PAC ID: 8123029691 Enrollment ID: I20070125000495 |
| Provider Name | Natali Amaradasa |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1881000255 PECOS PAC ID: 9638491814 Enrollment ID: I20141124002372 |
| Provider Name | Edith H. Odom |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023760626 PECOS PAC ID: 8325384910 Enrollment ID: I20220307000259 |
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