Organization
GRAND STRAND UROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRIS B RICHARDSON (EXECUTIVE DIRECTOR)
(843) 449-1010
Entity
Organization
Contact information
Practice address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
(843) 497-6171
Mailing address
823 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 449-1010
(843) 497-6171
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1418
—
SC
Enumeration date
11/04/2005
Last updated
08/22/2020
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