Individual
IRIDI PAVLIQOTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8004 MYRTLE TRACE DR STE 200, CONWAY, SC 29526-8945
(843) 347-8041
(843) 347-8042
Mailing address
300 SINGLETON RIDGE RD, ATTN CREDENTIALING, CONWAY, SC 29526-9142
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
93646
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
936465
—
SC
Enumeration date
04/11/2019
Last updated
11/21/2025
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