Organization
PPCP SPECIALTY PHYSICIANS , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY CUNNINGHAM (CEO)
(843) 695-6071
Entity
Organization
Contact information
Practice address
3030 ASHLEY TOWN CENTER DR STE 102A, CHARLESTON, SC 29414-5678
(843) 258-4994
(843) 507-8623
Mailing address
PO BOX 530062, ATLANTA, GA 30353-0062
(843) 695-6071
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8921
—
SC
Enumeration date
02/01/2019
Last updated
02/28/2022
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