TIDEWATER HEALTH PC NPI 1649773789

NPI Information

NPI: 1649773789
Provider Name: TIDEWATER HEALTH PC

Doing Business As: TIDEWATER HEALTH

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1435 STUART ENGALS BLVD STE 101
MOUNT PLEASANT, SC
ZIP 29464
Phone: (843) 800-5686
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TIDEWATER HEALTH PC is a primary care clinic center in Mount Pleasant, SC. TIDEWATER HEALTH PC NPI is 1649773789. The provider is registered as an organization entity type.
The provider Is Doing Business As Tidewater Health.

The provider's business location address is:

1435 STUART ENGALS BLVD STE 101
MOUNT PLEASANT, SC
ZIP 29464-312
Phone: (843) 800-5686
Fax: (843) 800-5656

The provider's authorized official is David L Smith .
The authorized official title is President and has the following contact phone number (843) 800-5686.

The enumeration date for this NPI number is 3/15/2018 and was last updated on 5/1/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

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: 5/5/2024

NPI Synchronization or Removal

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