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Organization
WACCAMAW GASTROENTEROLOGY, PC
Active
Organization
WACCAMAW GASTROENTEROLOGY, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURENCE HAVENS BALLOU MD (PARTNER)
(843) 527-3428
Entity
Organization
Contact information
Practice address
1011 N FRASER ST, GEORGETOWN, SC 29440-2848
(843) 527-3428
(843) 546-8216
Mailing address
1011 N FRASER ST, GEORGETOWN, SC 29440-2848
(843) 527-3428
(843) 546-8216
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
NULL
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
05/19/2006
Last updated
02/05/2008
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