Organization
HARTSVILLE MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUZ YOLANDA MENDEZ MD (PHYSICIAN)
(646) 683-3793
Entity
Organization
Contact information
Practice address
206 SWIFT CREEK RD, HARTSVILLE, SC 29550-4383
(843) 917-4117
Mailing address
PO BOX 247, HARTSVILLE, SC 29551-0247
(843) 917-4117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
32800
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609197623
NPI
SC
05
—
GP7551
—
SC
01
—
SC12769293
PROVIDER PTAN
—
Enumeration date
09/06/2016
Last updated
06/13/2017
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