Organization
COLLETON HEART CENTER, LLC
Active
Organization
COLLETON HEART CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN M GREGORY M.D. (OWNER)
(843) 549-3400
Entity
Organization
Contact information
Practice address
415 ROBERTSON BLVD STE C, WALTERBORO, SC 29488-5713
(843) 549-3400
(843) 549-1424
Mailing address
415 ROBERTSON BLVD STE C, WALTERBORO, SC 29488-5713
(843) 549-3400
(843) 549-1424
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
21611
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417940792
INDIVIDUAL NPI #
SC
05
—
216117
—
SC
Enumeration date
03/05/2007
Last updated
08/22/2020
Update your record
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