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Organization
SUMTER OBGYN PA
Active
Organization
SUMTER OBGYN PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TRACIE SCURRY (CREDENTIALING/INS/BILLING)
(803) 775-8351
Entity
Organization
Contact information
Practice address
115 N SUMTER ST, SUITE 200, SUMTER, SC 29150-4972
(803) 775-8351
(803) 773-2635
Mailing address
PO BOX 1469, SUMTER, SC 29151-1469
(803) 775-8351
(803) 773-2635
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA1346
—
SC
Enumeration date
03/17/2006
Last updated
10/29/2007
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