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Individual

MRS. DANA BETTINA POURNARAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D

Contact information

Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 497-5929
(843) 839-4448
Mailing address
4615 OLEANDER DR, SUITE 103, MYRTLE BEACH, SC 29577-5741
(843) 497-5929
(843) 839-4448

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TL35193
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
351933
SC
01
TL35193
STATE LICENSE
SC
Enumeration date
07/08/2009
Last updated
11/13/2012
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