Organization
PEE DEE FOOT CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN V. COREY D.P.M. (PRESIDENT)
(843) 355-9690
Entity
Organization
Contact information
Practice address
402 NELSON BLVD, SUITE 300, KINGSTREE, SC 29556-4058
(843) 355-9690
(843) 355-9777
Mailing address
402 NELSON BLVD, SUITE 300, KINGSTREE, SC 29556-4058
(843) 355-9690
(843) 355-9777
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
527
SC
213ES0103X
Foot & Ankle Surgery Podiatrist
532
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CF8526
RAILROAD MEDICARE
SC
01
—
DE1502
MEDICAID DME
SC
05
—
GP9963
—
SC
Enumeration date
10/18/2006
Last updated
04/22/2008
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