Organization
CCMMA SC LLC
Active
Organization
CCMMA SC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
COREY SCURLOCK MD (MEMBER)
(914) 523-2189
Entity
Organization
Contact information
Practice address
129 N WASHINGTON ST, SUMTER, SC 29150-4949
(803) 774-9000
Mailing address
PO BOX 631797, CINCINNATI, OH 45263-1797
(845) 702-2711
(888) 220-6560
Taxonomy
Speciality
Code
Description
License number
State
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
—
—
207RP1001X
Pulmonary Disease Physician
—
—
Other
Enumeration date
10/01/2018
Last updated
04/28/2025
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