Individual
SKERDILAID LICAJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
1714 HIGHWAY 17 S, NORTH MYRTLE BEACH, SC 29582-4041
(843) 545-7200
(843) 545-5742
Mailing address
7603 DRIFTWOOD DR, MYRTLE BEACH, SC 29572-4153
(843) 692-9099
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1212
SC
Other
Enumeration date
06/14/2007
Last updated
03/31/2008
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