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Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Other names
Tidelands Health Women's Center
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SUTHERLAND WARD (EVP & CFO)
(843) 527-7102
Entity
Organization
Contact information
Practice address
606 BLACK RIVER RD STE 300, GEORGETOWN, SC 29440-3304
(843) 546-3132
(843) 652-8441
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 520-8883
(843) 652-8422
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6200
—
SC
05
—
GP8147
—
SC
05
—
GP9003
—
SC
05
—
GP9079
—
SC
Enumeration date
03/11/2013
Last updated
06/25/2020
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