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GEORGETOWN PHYSICIAN ASSOCIATES LLC NPI 1518371137


NPI Information

NPI: 1518371137
Provider Name: GEORGETOWN PHYSICIAN ASSOCIATES, LLC

Doing Business As: TIDELANDS HEALTH SURGICAL SPECIALISTS

Classification: Surgery - 208600000X
Entity Type: Organization

CLIA Number: 42D2263926

Address:
4040 HIGHWAY 17 UNIT 104
MURRELLS INLET, SC
ZIP 29576
Phone: (843) 652-8390
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GEORGETOWN PHYSICIAN ASSOCIATES, LLC is a surgery in Murrells Inlet, SC. The provider is a general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. GEORGETOWN PHYSICIAN ASSOCIATES, LLC NPI is 1518371137. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Tidelands Health Surgical Specialists.

The provider's business location address is:

4040 HIGHWAY 17 UNIT 104
MURRELLS INLET, SC
ZIP 29576-098
Phone: (843) 652-8390
Fax: (843) 652-8399

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 CLIA number assigned to this NPI record is 42D2263926 - assisted living facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/12/2014 and was last updated on 8/5/2021.


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
1208600000XSurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP6535MEDICAIDSOUTH CAROLINA
2GP8839MEDICAIDSOUTH CAROLINA
3GP9181MEDICAIDSOUTH CAROLINA

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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