Organization
CONWAY ANESTHESIA SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES M PROCTOR MD (DIRECTOR)
(843) 488-1895
Entity
Organization
Contact information
Practice address
1405 MAIN ST, CONWAY, SC 29526-3568
(843) 488-2898
Mailing address
1405 MAIN ST, CONWAY, SC 29526-3568
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
367500000X
Certified Registered Nurse Anesthetist
—
—
Other
Enumeration date
11/19/2020
Last updated
07/14/2021
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