Organization
BEAUFORT PHYSICIAN PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH W MILLER (CFO)
(843) 522-5142
Entity
Organization
Contact information
Practice address
955 RIBAUT RD, BEAUFORT, SC 29902
(843) 522-5000
Mailing address
955 RIBAUT RD, BEAUFORT, SC 29902-5441
(843) 522-5200
(843) 522-5674
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BCBSSC
SC
05
—
PENDING
—
SC
Enumeration date
11/13/2017
Last updated
11/06/2019
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