|
| |
|
5046 Highway 17 Byp S Suite 104 Myrtle Beach SC 29588-4503 | |
| (843) 293-9955 | |
| (843) 293-9977 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Endocrinology, Diabetes & Metabolism |
| Location | 5046 Highway 17 Byp S, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Javaid H Wani (SOLE MEMBER) |
| Authorized Official Contact | 8432939955 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
5046 Highway 17 Byp S Suite 104 Myrtle Beach SC 29588-4503 Ph: (843) 293-9955 | 5046 Highway 17 Byp S Suite 104 Myrtle Beach SC 29588-4503 Ph: (843) 293-9955 |
| NPI Number | 1114341278 |
|---|---|
| Provider Enumeration Date | 02/10/2014 |
| Last Update Date | 07/18/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114341278 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | MD32116 (South Carolina) | Primary |
Southeastern Hospitalist Services Pc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 809 82nd Pkwy, Myrtle Beach, SC 29572 Phone: 843-692-1000 | |
Strand Regional Specialty Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8170 Rourk St, Myrtle Beach, SC 29572 Phone: 843-449-2336 Fax: 843-497-2505 | |
Healogics Specialty Physicians Of South Carolina, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5050 Highway 17 Byp S, Myrtle Beach, SC 29588 Phone: 843-839-6000 | |
La Bella Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2020 Oakheart Rd, Myrtle Beach, SC 29579 Phone: 843-424-3015 | |
Jga Medical Ventures, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4798 Woodview Ln, Myrtle Beach, SC 29575 Phone: 843-828-3352 Fax: 843-357-1471 |