Organization
THE REGIONAL MEDICAL CENTER
Active
Other names
DBA:Dr. Stewart Funderburk
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GOODLETT (CFO)
(803) 395-2200
Entity
Organization
Contact information
Practice address
870 HOLLY ST, ORANGEBURG, SC 29115-4831
(803) 395-2060
(803) 395-0998
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-2060
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4407
—
SC
Enumeration date
05/19/2006
Last updated
08/22/2020
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