Individual
CLYDE J DELLINGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4303 LIVE OAK DR, LITTLE RIVER, SC 29566-9138
(843) 663-1013
(843) 663-1017
Mailing address
PO BOX 547, LITTLE RIVER, SC 29566-0547
(843) 663-1013
(843) 663-1017
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
6674
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FQC024
—
SC
Enumeration date
05/18/2006
Last updated
01/27/2011
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