Organization
SOUTHEASTERN HOSPITALIST SERVICES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID WESLEY TEMPLETON MD (PRESIENT)
(800) 424-3672
Entity
Organization
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
PO BOX 638981, CINCINNATI, OH 45263-8981
(800) 424-3672
(954) 377-3042
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208M00000X
Hospitalist Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7085
—
SC
05
—
GP7097
—
GA
05
—
GP7098
—
GA
05
—
GP7099
—
SC
Enumeration date
11/30/2015
Last updated
05/19/2016
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