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Organization
WACCAMAW UROLOGY ASSOCIATES
Active
Organization
WACCAMAW UROLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS S CERASARO MD (PRESIDENT)
(842) 833-3428
Entity
Organization
Contact information
Practice address
3911A HIGHWAY 17, MURRELLS INLET, SC 29576-5014
(438) 652-4000
(843) 652-4004
Mailing address
3911 HIGHWAY 17 STE A, MURRELLS INLET, SC 29576-5014
(438) 652-4000
(843) 652-4004
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
12505SC
SC
208800000X
Urology Physician
17277
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0856
—
SC
Enumeration date
10/26/2006
Last updated
12/05/2024
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