Organization
CONWAY ADULT MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IRENE MARTIN (OFFICE MANAGER)
(843) 248-7568
Entity
Organization
Contact information
Practice address
903 BELL ST, CONWAY, SC 29526-4113
(843) 248-7568
(843) 248-3906
Mailing address
903 BELL ST, CONWAY, SC 29526-4113
(843) 248-7568
(843) 248-3906
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
12032
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA8688
—
SC
Enumeration date
04/17/2006
Last updated
06/21/2010
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