Organization
SOUTH CAROLINA RETINA INSTITUTE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS D MARCHASE MD (OWNER)
(205) 907-3912
Entity
Organization
Contact information
Practice address
1404 MAIN ST, CONWAY, SC 29526-3567
(205) 907-3912
Mailing address
1404 MAIN ST, CONWAY, SC 29526-3567
(843) 488-1100
(843) 488-7701
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
—
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
—
Other
Enumeration date
02/26/2020
Last updated
09/11/2020
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