Organization
CONWAY HOSPITAL COMMUNITY SERVICES
Active
Other names
CPG Coastal Metabolic & Bariatric Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRET A BARR (CFO)
(843) 347-7111
Entity
Organization
Contact information
Practice address
2376 CYPRESS CIR, SUITE 103, CONWAY, SC 29526-8964
(843) 347-3900
(843) 347-3930
Mailing address
PO BOX 2180, CONWAY, SC 29528-2180
(843) 234-5139
(843) 234-6822
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4505
—
SC
Enumeration date
11/10/2010
Last updated
05/10/2016
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