Individual
TARA-MARIE DINITTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
849 82ND PKWY, MYRTLE BEACH, SC 29572-4614
(843) 497-6348
(843) 497-6351
Mailing address
849 82ND PKWY, MYRTLE BEACH, SC 29572-4614
(843) 497-6348
(843) 497-6351
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
83046
SC
2086S0102X
Surgical Critical Care Physician
83046
SC
390200000X
Student in an Organized Health Care Education/Training Program
244202
NY
Other
Enumeration date
05/13/2013
Last updated
11/05/2019
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