Individual
STEPHEN ANDREW PENTHEROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5010
Mailing address
8121 ROURK ST, MYRTLE BEACH, SC 29572-4128
(843) 692-5000
(843) 692-5010
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
306726-1
NY
363LA2200X
Adult Health Nurse Practitioner
310357
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
32014
SC
Other
Enumeration date
11/08/2011
Last updated
05/27/2026
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