Organization
HERITAGE MEDICAL PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEANIE L MOORE (OFFICE MANAGER)
(843) 681-5305
Entity
Organization
Contact information
Practice address
460 WILLIAM HILTON PKWY, HILTON HEAD, SC 29926-2497
(843) 681-5305
(843) 689-6946
Mailing address
PO BOX 21743, HILTON HEAD, SC 29925-1743
(843) 681-5305
(843) 689-6946
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP2415
—
SC
Enumeration date
10/03/2006
Last updated
10/29/2010
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