Organization
WACCAMAW DERMATOLOGY AND PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS E QUIRKE MD (PRESIDENT)
(843) 449-0453
Entity
Organization
Contact information
Practice address
917 MEDICAL CIRCLE, MYRTLE BEACH, SC 29572-4116
(843) 449-0453
(843) 497-4822
Mailing address
917 MEDICAL CIRCLE, MYRTLE BEACH, SC 29572-4116
(843) 449-0453
(843) 497-4822
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1554
—
SC
Enumeration date
09/10/2008
Last updated
09/25/2008
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