Individual
EDWARD L PROCTOR JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
923 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 503-5442
(843) 449-6213
Mailing address
923 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 503-5442
(843) 449-6213
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
10303
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
10303
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103033
—
SC
05
—
890659V
—
NC
Enumeration date
01/24/2006
Last updated
06/06/2016
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