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GEORGETOWN PHYSICIAN ASSOCIATES LLC NPI 1053967943


NPI Information

NPI: 1053967943
Provider Name: GEORGETOWN PHYSICIAN ASSOCIATES, LLC

Doing Business As: TIDELANDS HEALTH PEDIATRICS

Classification: Pediatrics - 208000000X
Entity Type: Organization
Address:
4320 HOLMESTOWN RD STE B
MYRTLE BEACH, SC
ZIP 29588
Phone: (843) 652-8440
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GEORGETOWN PHYSICIAN ASSOCIATES, LLC is a pediatrics in Myrtle Beach, SC. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. GEORGETOWN PHYSICIAN ASSOCIATES, LLC NPI is 1053967943. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Tidelands Health Pediatrics.

The provider's business location address is:

4320 HOLMESTOWN RD STE B
MYRTLE BEACH, SC
ZIP 29588-837
Phone: (843) 652-8440
Fax: (843) 652-8441

The provider's authorized official is Elizabeth Sutherland Ward .
The authorized official title is Evp & Cfo and has the following contact phone number (843) 527-7102.

The enumeration date for this NPI number is 8/15/2019 and was last updated on 5/1/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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