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Organization

MYRTLE BEACH INTERNISTS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. VICTORIA E MOSHOURES MD (OWNER)
(843) 839-2500
Entity
Organization

Contact information

Practice address
929 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 839-2500
(843) 839-0018
Mailing address
929 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 839-2500
(843) 839-0018

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20432
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3365
SC
Enumeration date
08/29/2007
Last updated
08/29/2007
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