# AMSOL PHYSICIANS OF WALTERBORO SC LLC

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

## Provider details

- **NPI number:** 1750474128
- **Authorized official:** ALAN DALE HILLIARD CPA (MANAGER)
- **Authorized official phone:** (843) 549-2000

## Contact information

- **Practice address:** 501 ROBERTSON BLVD, WALTERBORO, SC 29488-2787
- **Practice address phone:** (843) 549-2000
- **Mailing address:** 501 ROBERTSON BLVD, WALTERBORO, SC 29488-2787
- **Mailing address phone:** (843) 549-2000

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207L00000X | Anesthesiology Physician | — | NULL | Yes |
| 207L00000X | Anesthesiology Physician | — | — | Yes |

## Other

- **Enumeration date:** 09/30/2006
- **Last updated:** 04/20/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | DC4043 | RR MEDICARE | SC |
| 05 | — | GP4035 | — | SC |