Organization
CONWAY HOSPITAL COMMUNITY SERVICES
Active
Other names
Conway Physicians Group
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
1213 ELM ST, AYNOR, SC 29511-3320
(843) 358-5806
(843) 358-9205
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
828
SC
207Q00000X
Family Medicine Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
20362
SC
207Y00000X
Otolaryngology Physician
21986
SC
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4505
—
SC
05
—
GP6275
—
SC
05
—
RHC194
—
SC
05
—
RHC224
—
SC
Enumeration date
02/22/2007
Last updated
04/28/2023
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