| Tidelands Health Family Medicine | |
|
4301 Dick Pond Rd Myrtle Beach SC 29588 | |
| (843) 652-8100 | |
| (843) 652-8122 |
| Full Name | Tidelands Health Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 4301 Dick Pond Rd, Myrtle Beach, South Carolina |
| Authorized Official Name and Position | Elizabeth Sutherland Ward (EVP & CFO) |
| Authorized Official Contact | 8435277102 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tidelands Health Family Medicine Po Box 421718 Georgetown SC 29442-4203 Ph: (843) 520-8883 | Tidelands Health Family Medicine 4301 Dick Pond Rd Myrtle Beach SC 29588 Ph: (843) 652-8100 |
| NPI Number | 1679987028 |
|---|---|
| Provider Enumeration Date | 06/13/2014 |
| Last Update Date | 05/01/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679987028 | NPI | - | NPPES |
| GP6523 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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