Individual
ERIC SAMUEL YOUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3980 HIGHWAY 9 E, SUITE 100-C, LITTLE RIVER, SC 29566-8163
(843) 399-9774
(843) 399-8657
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 399-9774
(843) 399-8657
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
22220
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GP5462
GROUP MEDICAID
SC
05
—
N0042
—
SC
05
—
N00742
—
SC
Enumeration date
06/15/2006
Last updated
06/15/2016
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