Organization
ADVANCED UROLOGY OF THE PEE DEE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN R. EVANS MD (OWNER)
(843) 618-8609
Entity
Organization
Contact information
Practice address
309 W PINE ST, FLORENCE, SC 29501-4726
(843) 618-8609
Mailing address
PO BOX 100523, FLORENCE, SC 29502-0523
(843) 669-5162
(843) 667-4573
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DW2056
RAILROAD MEDICARE
SC
05
—
GP6980
—
SC
Enumeration date
08/21/2015
Last updated
02/23/2016
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