Organization
EDISTO ORTHOPAEDICS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY A HOLMAN M.D. (SURGEON)
(843) 782-4141
Entity
Organization
Contact information
Practice address
302 MEDICAL PARK DR, SUITE 111, WALTERBORO, SC 29488-5747
(843) 782-4141
(843) 549-7967
Mailing address
302 MEDICAL PARK DR, SUITE 111, WALTERBORO, SC 29488-5747
(843) 782-4141
(843) 549-7967
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2610
—
SC
Enumeration date
01/19/2007
Last updated
01/20/2010
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