Individual
EUGENIA GAINZEO COOPER-MERCHANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
100 PROFESSIONAL PARK DR, CONWAY, SC 29526-9260
(843) 234-0005
Mailing address
100 PROFESSIONAL PARK DR, CONWAY, SC 29526-9260
(843) 234-0005
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
20544
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129195
—
SC
Enumeration date
09/14/2006
Last updated
03/13/2017
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