Edgewater Medical Center
Family Medicine in Fort Mill, SC. Organization (NPI-2).
NPI number1184878423
StatusActive
Last updated in NPPESNov 13, 2008
Details
- NPI
- 1184878423
- Entity type
- Organization (NPI-2)
- Legal business name
- Edgewater Medical Center
- Organization subpart
- No
- Enumeration date
- Nov 13, 2008
- Last updated
- Nov 13, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – |
Practice location
1162 Fort Mill HwySuite A
Fort Mill, SC 29707-7511
Phone 803-396-7900 · Fax 803-396-2963
Mailing address
1162 Fort Mill HwySuite A
Fort Mill, SC 29707-7511
Phone 803-396-7900 · Fax 803-396-2963
Authorized official
Brian A Walker
Physician/Partner
8033967900
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