Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Other names
Tidelands Health Pain Management Services
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SUTHERLAND WARD (EVP & CFP)
(843) 527-7102
Entity
Organization
Contact information
Practice address
4040 HIGHWAY 17 UNIT 206, MURRELLS INLET, SC 29576-5098
(843) 652-8260
(843) 652-8269
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 520-8883
(843) 652-8422
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
—
—
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7010
—
SC
Enumeration date
03/06/2015
Last updated
06/25/2020
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