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Organization

DURST FAMILY MEDICINE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
WANDA BROWN (OFFICE MANAGER)
(843) 883-3176
Entity
Organization

Contact information

Practice address
306 STATION 22 12, SULLIVANS ISLAND, SC 29482-9768
(843) 883-3176
(843) 883-3459
Mailing address
306 STATION 22 1/2, SULLIVANS ISLAND, SC 29483-9768
(843) 883-3176
(843) 883-3459

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1174508378
NPI
SC
01
1699750893
NPI
SC
05
GP3335
SC
Enumeration date
12/11/2006
Last updated
07/21/2022
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