# OCC DOC OF SOUTH CAROLINA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1316089485
- **Authorized official:** DR. REGINA A ROMAN D.O. (OWNER PHYSICIAN)
- **Authorized official phone:** (843) 347-5752

## Contact information

- **Practice address:** 154 WACCAMAW MEDICAL PARK CT \# A, CONWAY, SC 29526-8965
- **Practice address phone:** (843) 347-5752
- **Mailing address:** 154 WACCAMAW MEDICAL PARK CT \# A, CONWAY, SC 29526-8965
- **Mailing address phone:** (843) 347-5752

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | 0390 | SC | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 08/22/2020