Organization
AMSOL PHYSICIANS OF WALTERBORO SC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALAN DALE HILLIARD CPA (MANAGER)
(843) 549-2000
Entity
Organization
Contact information
Practice address
501 ROBERTSON BLVD, WALTERBORO, SC 29488-2787
(843) 549-2000
Mailing address
501 ROBERTSON BLVD, WALTERBORO, SC 29488-2787
(843) 549-2000
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC4043
RR MEDICARE
SC
05
—
GP4035
—
SC
Enumeration date
09/30/2006
Last updated
04/20/2008
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