Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Other names
Tidelands Health Cardiology
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SUTHERLAND WARD (EVP & CFO)
(843) 527-7102
Entity
Organization
Contact information
Practice address
9653 OCEAN HWY, PAWLEYS ISLAND, SC 29585
(843) 235-3131
(843) 237-9797
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 520-8883
(843) 652-8422
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP7534
—
SC
05
—
GP7636
—
SC
05
—
GP7637
—
SC
05
—
GP8364
—
SC
05
—
GP8697
—
SC
05
—
GP8840
—
SC
Enumeration date
08/23/2016
Last updated
04/14/2022
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