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Organization
FLEETWOOD INTERNAL MEDICINE PA
Active
Organization
FLEETWOOD INTERNAL MEDICINE PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAWRENCE E STROUD JR. MD (PRESIDENT)
(864) 855-1036
Entity
Organization
Contact information
Practice address
109B FLEETWOOD DR, EASLEY, SC 29640-2019
(864) 855-1036
(864) 855-3318
Mailing address
PO BOX 309, PICKENS, SC 29671-0309
(864) 850-1441
(864) 850-1482
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
851
SC
207QA0401X
Addiction Medicine (Family Medicine) Physician
8878
SC
207RC0000X
Cardiovascular Disease Physician
9099
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA4726
—
SC
Enumeration date
09/21/2005
Last updated
10/31/2007
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