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Organization
SEASIDE FAMILY MEDICINE, LLC
Active
Organization
SEASIDE FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA E. MCALLISTER NP (NP, OWNER)
(843) 400-0028
Entity
Organization
Contact information
Practice address
1341 COLLEGE PARK RD # A, SUMMERVILLE, SC 29486
(843) 400-0028
(843) 790-8449
Mailing address
1341 COLLEGE PARK RD # A, SUMMERVILLE, SC 29486-8635
(843) 400-0028
(843) 790-8449
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP0200X
Pediatric Nurse Practitioner
18442
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP2488
—
SC
Enumeration date
04/19/2018
Last updated
08/13/2018
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