Organization
MILL STREET MEDICAL ASSOCIATES, LLP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAREN H LANE (BILLING)
(803) 432-3379
Entity
Organization
Contact information
Practice address
1113 MILL ST, CAMDEN, SC 29020-3763
(803) 432-3379
Mailing address
1113 MILL ST, CAMDEN, SC 29020-3763
(803) 432-3379
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15151
SC
207R00000X
Internal Medicine Physician
3592
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4375
—
SC
Enumeration date
08/18/2006
Last updated
10/10/2007
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