GEORGETOWN PHYSICIAN SERVICES LLC NPI 1962691402

NPI Information

  • NPI: 1962691402
  • Provider Name: GEORGETOWN PHYSICIAN SERVICES, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • Doing Business As: WACCAMAW FAMILY MEDICINE
  • Address: 9699 OCEAN HWY
    PAWLEYS ISLAND, SC
    ZIP 29585
  • Phone: (843) 237-4296

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NPI Details

GEORGETOWN PHYSICIAN SERVICES, LLC is a family medicine in Pawleys Island, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. GEORGETOWN PHYSICIAN SERVICES, LLC NPI is 1962691402. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Waccamaw Family Medicine.

The provider's business location address is:

9699 OCEAN HWY
PAWLEYS ISLAND, SC
ZIP 29585-425
Phone: (843) 237-4296
Fax: (843) 237-0495

The provider's authorized official is Sue R. Stark .
The authorized official title is Co-administrator and has the following contact phone number (843) 527-4442.

The enumeration date for this NPI number is 10/22/2007 and was last updated on 11/3/2010.

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
1207Q00000XFamily MedicineYes

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
18938MEDICARE PINSOUTH CAROLINA
2GP1370MEDICAIDSOUTH CAROLINA
3GP4819MEDICAIDSOUTH CAROLINA
4423870MEDICARE OSCAR/CERTIFICATIONSOUTH CAROLINA
55078MEDICARE PIN

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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