Organization
PALMETTO OBGYN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OLUBUNMI ASHABI ALO MD (MD)
(843) 353-2111
Entity
Organization
Contact information
Practice address
3864 RENEE DRIVE, MYRTLE BEACH, SC 29579
(843) 353-2111
(843) 628-4326
Mailing address
PO BOX 51827, MYRTLE BEACH, SC 29579-0031
(843) 353-2111
(843) 628-4326
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP9634
—
SC
Enumeration date
03/16/2020
Last updated
10/16/2020
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