Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON S PERCIVAL DPM (PRESIDENT)
(803) 285-1411
Entity
Organization
Contact information
Practice address
1190 HIGHWAY 9 BYP W, LANCASTER, SC 29720-1709
(803) 285-1411
(803) 283-9920
Mailing address
8141 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 492-2293
(888) 383-6797
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
213ES0131X
Foot Surgery Podiatrist
—
—
Other
Enumeration date
01/15/2014
Last updated
07/18/2014
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