Organization
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Active
Other names
Tidelands Health Family Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH SUTHERLAND WARD (EVP & CFO)
(843) 527-7102
Entity
Organization
Contact information
Practice address
12117 OCEAN HWY, PAWLEYS ISLAND, SC 29585
(843) 237-8231
(843) 237-8551
Mailing address
PO BOX 421718, GEORGETOWN, SC 29442-4203
(843) 520-8883
(843) 652-8422
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6125
—
SC
Enumeration date
12/28/2012
Last updated
06/25/2020
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