Organization
EDISTO REGIONAL HEALTH SERVICES
Active
Other names
St Matthews Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
LISA M GOODLETT (C.O.O.)
(803) 395-2200
Entity
Organization
Contact information
Practice address
725 HARRY C RAYSOR DR, ST MATTHEWS, SC 29135-8403
(803) 874-3902
(803) 874-3905
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 536-0998
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
07/27/2009
Last updated
01/30/2012
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