# GEORGETOWN PHYSICIAN ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tidelands Health Gastroenterology
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093139420
- **Authorized official:** ELIZABETH SUTHERLAND WARD (EVP & CFO)
- **Authorized official phone:** (843) 527-7102

## Contact information

- **Practice address:** 1011 N FRASER ST, GEORGETOWN, SC 29440
- **Practice address phone:** (843) 527-3428
- **Practice address fax:** (843) 546-8216
- **Mailing address:** PO BOX 421718, GEORGETOWN, SC 29442-4203
- **Mailing address phone:** (843) 520-8883
- **Mailing address fax:** (843) 652-8422

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 02/05/2014
- **Last updated:** 06/25/2020