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Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON PERCIVAL DPM (PRESIDENT)
(803) 285-1411
Entity
Organization
Contact information
Practice address
1 MEDICAL PARK DR STE C, CHESTER, SC 29706-9769
(803) 285-1411
Mailing address
8141 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 492-2293
(888) 383-6797
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
NULL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
—
—
Other
Enumeration date
02/19/2014
Last updated
07/18/2014
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