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Individual

DOUGLAS S HEAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4630 HWY 17 BYPASS, MURRELLS INLET, SC 29576-2662
(843) 357-1299
(843) 357-2264
Mailing address
5046 HIGHWAY 17 BYP S, STE 100, MYRTLE BEACH, SC 29588-4503
(843) 234-5139
(843) 234-6822

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
12647
SC
207RC0000X
Cardiovascular Disease Physician
Primary
12647
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
126474
SC
05
GP0975
SC
Enumeration date
08/19/2005
Last updated
07/25/2019
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