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Organization
GEORGETOWN PHYSICIAN ASSOCIATES LLC
Active
Organization
GEORGETOWN PHYSICIAN ASSOCIATES LLC
Active
Other names
Tidelands Health Group
Organization subpart
No
Provider details
NPI number
Authorized official
ERIN SHAFFER BEADLE (CHIEF FINANCIAL OFFICER (CFO)/EVP)
(843) 520-8617
Entity
Organization
Contact information
Practice address
606 BLACK RIVER RD STE 300, GEORGETOWN, SC 29440-3304
(843) 652-8290
(843) 546-8216
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207PE0005X
Undersea and Hyperbaric Medicine (Emergency Medicine) Physician
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RH0003X
Hematology & Oncology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
207Y00000X
Otolaryngology Physician
—
—
208000000X
Pediatrics Physician
—
—
2084N0400X
Neurology Physician
—
—
208600000X
Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Enumeration date
11/26/2024
Last updated
01/13/2025
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