Individual
DR. ALEX BRIAN MCINTYRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
933 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 497-7772
(843) 497-7627
Mailing address
933 MEDICAL CIR, MYRTLE BEACH, SC 29572-4116
(843) 497-7772
(843) 497-7627
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
12574
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12574
SC LICENSE NUMBER
SC
05
—
125741
—
SC
01
—
582426964
TAX ID
SC
01
—
780001419
RAILROAD MEDICARE
SC
01
—
790608T
NC MEDICAID
NC
Enumeration date
08/12/2006
Last updated
06/22/2016
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