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Organization
WATERWAY FAMILY MEDICINE, PA
Active
Organization
WATERWAY FAMILY MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHERRY BUFFKIN (INSURANCE CLERK)
(843) 756-5300
Entity
Organization
Contact information
Practice address
3600 SEA MOUNTAIN HWY., SUITE C, LITTLE RIVER, SC 29566-7640
(843) 399-4848
(843) 756-6059
Mailing address
3439 CASEY ST, LORIS, SC 29569-2903
(843) 756-5300
(843) 756-6059
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0291H
BCBS
NC
01
—
890291H
NC MEDICAID
NC
01
—
CM7718
RAILROAD MEDICARE
—
05
—
GP1062
—
SC
Enumeration date
07/20/2005
Last updated
07/21/2022
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