Organization
TIDES GASTROENTEROLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY DOROCIAK (PRESIDENT)
(843) 743-4241
Entity
Organization
Contact information
Practice address
159 E SHIPYARD RD, MT PLEASANT, SC 29464-2677
(843) 743-4241
Mailing address
159 E SHIPYARD RD, MT PLEASANT, SC 29464-2677
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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