Individual
AMANDA JACQUELYN DIDOLKAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4022 POSTAL WAY STE C, MYRTLE BEACH, SC 29579-3537
(843) 903-4111
(843) 903-4242
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PATIENT ACCOUNTING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
84825
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
848257
—
SC
05
—
Q027544
—
TN
Enumeration date
06/30/2008
Last updated
04/11/2024
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