Individual
DALAL A AKOURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4710 OLEANDER DRIVE, MYRTLE BEACH, SC 29577-5898
(843) 213-1480
(843) 712-1973
Mailing address
4710 OLEANDER DRIVE, MYRTLE BEACH, SC 29577-5898
(843) 213-1480
(843) 712-1973
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101046726
VA
207Q00000X
Family Medicine Physician
9800006
NC
208000000X
Pediatrics Physician
9800006
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010256135
—
VA
05
—
010289661
—
VA
05
—
3069481
—
TN
05
—
3069481
—
VA
01
—
3136318
BLUE CROSS BLUE SHEILD
TN
01
—
P00387371
RAILROAD MEDICARE
TN
Enumeration date
07/02/2006
Last updated
04/18/2012
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