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Organization
DURST FAMILY MEDICINE
Active
Organization
DURST FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA BROWN (OFFICE MANAGER)
(843) 883-3176
Entity
Organization
Contact information
Practice address
306 STATION 22 12, SULLIVANS ISLAND, SC 29482-9768
(843) 883-3176
(843) 883-3459
Mailing address
306 STATION 22 1/2, SULLIVANS ISLAND, SC 29483-9768
(843) 883-3176
(843) 883-3459
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1174508378
NPI
SC
01
—
1699750893
NPI
SC
05
—
GP3335
—
SC
Enumeration date
12/11/2006
Last updated
07/21/2022
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