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Individual

DR. MARY KAYE FAVARO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
1407 SOUTHWOOD DR, SURFSIDE BEACH, SC 29575-5365
(843) 215-6992
(843) 215-9409
Mailing address
1407 SOUTHWOOD DR, SURFSIDE BEACH, SC 29575-5365
(843) 215-6992
(843) 215-9409

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
17183
WI
207Q00000X
Family Medicine Physician
Primary
6170
SC

Other

Enumeration date
08/22/2006
Last updated
07/08/2007
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