Organization
WACCAMAW SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY LENTZ FRY MD (OWNER)
(843) 546-7272
Entity
Organization
Contact information
Practice address
401 MARINA DR, GEORGETOWN, SC 29440-2410
(843) 546-7272
(843) 546-0277
Mailing address
401 MARINA DR, GEORGETOWN, SC 29440-2410
(843) 546-7272
(843) 546-0277
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
14277
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
14277
—
SC
Enumeration date
02/20/2007
Last updated
06/13/2008
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