Organization
J VANCE VANDERGRIFF MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH VANCE VANDERGRIFF M.D. (OWNER)
(843) 461-0166
Entity
Organization
Contact information
Practice address
3955 HIGHWAY 17 BYPASS, MURRELLS INLET, SC 29576
(843) 461-0166
Mailing address
PO BOX 1749, MURRELLS INLET, SC 29576-1749
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21773
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T58261
—
SC
Enumeration date
08/02/2013
Last updated
08/02/2013
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