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Individual

REBECCA DIANE CODY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5015
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5015

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
200100855
NC
207RH0003X
Hematology & Oncology Physician
Primary
22443
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89064HW
NC
05
T67291
SC
Enumeration date
08/30/2005
Last updated
06/14/2012
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