Organization
SOUTH CAROLINA PODIATRIC PHYSICIANS AND SURGEONS GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON PERCIVAL DPM (PRESIDENT)
(803) 285-1411
Entity
Organization
Contact information
Practice address
1575 E MAIN ST, DUNCAN, SC 29334-9218
(864) 487-3338
(864) 487-4102
Mailing address
8141 ROURK ST, MYRTLE BEACH, SC 29572-4128
(803) 285-1411
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
564
SC
Other
Enumeration date
02/27/2014
Last updated
05/08/2014
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