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Organization

SOUTHEAST LUNG & CRITICAL CARE SPECIALISTS, PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MELANEY G ODOM (ADMINISTRATOR)
(843) 682-2934
Entity
Organization

Contact information

Practice address
1010 MEDICAL CENTER DR, SUITE 100, HARDEEVILLE, SC 29927-3447
(843) 208-3584
Mailing address
23 MAIN ST, SUITE 202, HILTON HEAD, SC 29926-6606
(843) 682-2934

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
26860
SC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
26860
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
G44180
SC
Enumeration date
02/17/2011
Last updated
02/17/2011
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