WACCAMAW SURGICAL ASSOCIATES NPI 1710022660

NPI Information

  • NPI: 1710022660
  • Provider Name: WACCAMAW SURGICAL ASSOCIATES
  • Classification: Specialist - 174400000X
  • Entity Type: Organization
  • Address: 401 MARINA DR
    GEORGETOWN, SC
    ZIP 29440
  • Phone: (843) 546-7272

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NPI Details

WACCAMAW SURGICAL ASSOCIATES is a specialist in Georgetown, SC. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. WACCAMAW SURGICAL ASSOCIATES NPI is 1710022660. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

401 MARINA DR
GEORGETOWN, SC
ZIP 29440-410
Phone: (843) 546-7272
Fax: (843) 546-0277

The provider's authorized official is Terry Lentz Fry .
The authorized official title is Owner and has the following contact phone number (843) 546-7272.

The enumeration date for this NPI number is 2/20/2007 and was last updated on 6/13/2008.

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
1174400000XSpecialist14277SOUTH CAROLINAYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
114277MEDICAIDSOUTH CAROLINA
2C880150MEDICARE UPINSOUTH CAROLINA
3C880150281MEDICARE ID-TYPE UNSPECIFIEDSOUTH 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: 11/21/2025

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