Organization
NU SOUTH PROVIDERS
Active
Other names
Nu South Providers LLC
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAVIS (CREDENTIALING SPECIALISTS)
(912) 373-4385
Entity
Organization
Contact information
Practice address
117 NORTH HIGHWAY 52, UNIT 56, MONCKS CORNER, SC 29461-0056
(843) 900-7098
Mailing address
PO BOX 56, MONCKS CORNER, SC 29461-0056
(843) 900-7098
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/20/2024
Last updated
12/24/2024
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