# WACCAMAW GASTROENTEROLOGY, PC

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

## Provider details

- **NPI number:** 1548213564
- **Authorized official:** LAURENCE HAVENS BALLOU MD (PARTNER)
- **Authorized official phone:** (843) 527-3428

## Contact information

- **Practice address:** 1011 N FRASER ST, GEORGETOWN, SC 29440-2848
- **Practice address phone:** (843) 527-3428
- **Practice address fax:** (843) 546-8216
- **Mailing address:** 1011 N FRASER ST, GEORGETOWN, SC 29440-2848
- **Mailing address phone:** (843) 527-3428
- **Mailing address fax:** (843) 546-8216

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RG0100X | Gastroenterology Physician | — | NULL | Yes |
| 207RG0100X | Gastroenterology Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/19/2006
- **Last updated:** 02/05/2008