Organization
PHYSICIAN SERVICES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHARMAINE M GEORGE M.D. (OWNER/PHYSICIAN)
(803) 309-4788
Entity
Organization
Contact information
Practice address
214 LAKE FRONT DRIVE, PHYSICIAN SERVICES, COLA, SC 29212
(803) 309-4788
(866) 927-3065
Mailing address
214 LAKE FRONT DRIVE, COLA, SC 29212
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6800
—
SC
Enumeration date
10/09/2012
Last updated
11/22/2017
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