Individual
DR. AIMAR P MACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2376 CYPRESS CIRCLE, SUITE 202, CONWAY, SC 29526-8994
(843) 234-9700
(843) 234-6896
Mailing address
PO BOX 2180, CONWAY, SC 29528-2180
(843) 234-9700
(843) 234-6990
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
MD 28556
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
285569
—
SC
01
—
7844
MEDICARE PTAN
SC
05
—
89137Y6
—
NC
05
—
GP4505
—
SC
Enumeration date
08/25/2005
Last updated
10/05/2016
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