Organization
COMPLETE CARE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA J LESTER (BUSINESS MANAGER)
(804) 939-7037
Entity
Organization
Contact information
Practice address
1413 HIGHWAY 17 S, SUITE 1200, SURFSIDE BEACH, SC 29575-6040
(843) 631-4656
Mailing address
1413 HIGHWAY 17 S, SUITE 1200, SURFSIDE BEACH, SC 29575-6040
(843) 631-4656
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
09/19/2016
Last updated
09/19/2016
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