# SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982029799
- **Authorized official:** BRANDON PERCIVAL (PRESIDENT)
- **Authorized official phone:** (803) 285-1411

## Contact information

- **Practice address:** 2845 E HIGHWAY 76, MEDICAL PARK 2 STE 1, MULLINS, SC 29574-6037
- **Practice address phone:** (843) 431-2780
- **Practice address fax:** (843) 431-2786
- **Mailing address:** 8141 ROURK ST, MYRTLE BEACH, SC 29572-4128

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | 531 | SC | Yes |

## Other

- **Enumeration date:** 03/03/2014
- **Last updated:** 03/03/2014