Organization
GRAND STRAND GYNECOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BENJAMIN J. MARTIN M.D. (OWNER)
(843) 449-5553
Entity
Organization
Contact information
Practice address
911 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 449-5553
(843) 449-4453
Mailing address
4728 JENN DR, SUITE 104, MYRTLE BEACH, SC 29577-5714
(843) 449-5553
(843) 449-4453
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA4575
—
SC
Enumeration date
12/12/2006
Last updated
08/12/2010
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