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Organization

FOCUS SC 1009, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMES C WILEY MD (OWNER)
(251) 301-8276
Entity
Organization

Contact information

Practice address
900 BOWMAN RD, SUITE 303, MT PLEASANT, SC 29464
(843) 593-9332
Mailing address
900 BOWMAN RD, SUITE 303, MT. PLEASANT, SC 29464
(843) 593-9332
(251) 414-5809

Taxonomy

Speciality
Code
Description
License number
State
207QA0000X
Adolescent Medicine (Family Medicine) Physician
208000000X
Pediatrics Physician
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
2080P0006X
Developmental - Behavioral Pediatrics Physician

Other

Enumeration date
12/11/2013
Last updated
04/24/2017
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