Organization
SANTEE FAMILY MEDICAL CENTER, INC
Active
Other names
santee family medical center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GOSSIE C. HEATH MATHIS M.D. (MD)
(803) 854-3940
Entity
Organization
Contact information
Practice address
130 PLAZA CIR, SANTEE, SC 29142-9630
(803) 854-3940
Mailing address
PO BOX 277, SANTEE, SC 29142-0277
(803) 854-3940
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
13454
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0261
—
SC
Enumeration date
05/12/2010
Last updated
07/09/2010
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