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Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Other names
Tidelands Health Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SUTHERLAND WARD (EVP & CFO)
(843) 527-7102
Entity
Organization
Contact information
Practice address
4320 HOLMESTOWN RD STE A, MYRTLE BEACH, SC 29588-7837
(843) 652-8440
(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
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7739
—
SC
Enumeration date
04/19/2017
Last updated
05/01/2020
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