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Organization
CREEKSIDE WOMEN'S CARE, PA
Active
Organization
CREEKSIDE WOMEN'S CARE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS ALYCIA A LEAR (PRACTICE MANAGER)
(843) 769-5620
Entity
Organization
Contact information
Practice address
2097 HENRY TECKLENBURG DR, SUITE 312-W, CHARLESTON, SC 29414-5740
(843) 769-5620
(843) 769-5625
Mailing address
2097 HENRY TECKLENBURG DR, SUITE 312-W, CHARLESTON, SC 29414-5740
(843) 769-5620
(843) 769-5625
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47-1592
—
SC
Enumeration date
11/07/2006
Last updated
01/05/2016
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