Individual
TERESA REGINA KONTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
1109823
SC
390200000X
Student in an Organized Health Care Education/Training Program
Primary
1109823
SC
Other
Enumeration date
05/04/2022
Last updated
03/22/2023
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