Individual
COTY HP HO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
394 SINGLETON RIDGE RD, CONWAY, SC 29526-9150
(843) 347-8050
(843) 347-8049
Mailing address
300 SINGLETON RIDGE RD, ATTN CREDENTIALING, CONWAY, SC 29526-9142
Taxonomy
Speciality
Code
Description
License number
State
207RX0202X
Medical Oncology Physician
28280
OK
207RX0202X
Medical Oncology Physician
Primary
96236
SC
207RX0202X
Medical Oncology Physician
Primary
BH6437075
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
962363
—
SC
Enumeration date
01/19/2007
Last updated
04/14/2026
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