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Organization
CONWAY HOSPITAL, INC
Active
Organization
CONWAY HOSPITAL, INC
Active
Other names
CMC ENT, CONWAY HOSPITAL COMMUNITY SERVICES, CPG CAROLINA BAYS ENT
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
620 SINGLETON RIDGE RD, CONWAY, SC 29526-9154
(843) 347-7300
(843) 347-8459
Mailing address
300 SINGLETON RIDGE ROAD, ATTN PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
NULL
207Y00000X
Otolaryngology Physician
Primary
—
—
207YS0123X
Facial Plastic Surgery Physician
—
NULL
207YS0123X
Facial Plastic Surgery Physician
—
—
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
NULL
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
—
—
231H00000X
Audiologist
—
NULL
231H00000X
Audiologist
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4505
—
SC
05
—
PG0879
—
SC
05
—
PG0911
—
SC
Enumeration date
03/07/2006
Last updated
08/12/2022
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