Organization
ALLIANCE MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHANIE LEYVA (PRESIDENT)
(843) 225-7317
Entity
Organization
Contact information
Practice address
2179 ASHLEY PHOSPHATE RD STE B, NORTH CHARLESTON, SC 29406-4180
(843) 225-7317
(843) 225-7318
Mailing address
2179 ASHLEY PHOSPHATE RD STE B, NORTH CHARLESTON, SC 29406-4180
(843) 225-7317
(843) 225-7318
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6340
—
SC
Enumeration date
10/13/2011
Last updated
04/02/2015
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