Organization
CONWAY HOSPITAL, INC.
Active
Other names
Conway Hosptial Community Services, CMC SURGICAL ASSOCIATES, CMC Surgical Associates Socastee
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELLEN ARTIOLI (CREDENTIALING SPECIALIST)
(843) 234-6946
Entity
Organization
Contact information
Practice address
2361 CYPRESS CIR, CONWAY, SC 29526-8921
(843) 347-7291
(843) 347-0139
Mailing address
300 SINGLETON RIDGE RD, ATTN: PNS CREDENTIALING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
2086S0129X
Vascular Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP8766
—
SC
05
—
PG1508
—
SC
Enumeration date
12/19/2018
Last updated
04/25/2024
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