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GEORGETOWN PHYSICIAN ASSOCIATES LLC NPI 1629482435


NPI Information

NPI: 1629482435
Provider Name: GEORGETOWN PHYSICIAN ASSOCIATES, LLC

Doing Business As: TIDELANDS HEALTH ONCOLOGY

Classification: Internal Medicine - 207RX0202X
Entity Type: Organization

Specialization: Medical Oncology

Address:
2405 N FRASER ST
GEORGETOWN, SC
ZIP 29440
Phone: (843) 545-7274
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GEORGETOWN PHYSICIAN ASSOCIATES, LLC is a medical oncology internal medicine in Georgetown, SC. The provider is an internist who specializes in the diagnosis and treatment of all types of cancer and other benign and malignant tumors. This specialist decides on and administers therapy for these malignancies as well as consults with surgeons and radiotherapists on other treatments for cancer. GEORGETOWN PHYSICIAN ASSOCIATES, LLC NPI is 1629482435. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Tidelands Health Oncology.

The provider's business location address is:

2405 N FRASER ST
GEORGETOWN, SC
ZIP 29440
Phone: (843) 545-7274
Fax: (843) 545-8315

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 6/19/2014 and was last updated on 6/25/2020.


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
1207RX0202XInternal MedicineMedical OncologyYes

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
1GP7345MEDICAIDSOUTH CAROLINA
2GP6530MEDICAIDSOUTH 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: 11/14/2023

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