Complete Care Medical Group LLC
Dermatology in Surfside Beach, SC. Organization (NPI-2).
NPI number1982152906
StatusActive
Last updated in NPPESSep 19, 2016
Details
- NPI
- 1982152906
- Entity type
- Organization (NPI-2)
- Legal business name
- Complete Care Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Sep 19, 2016
- Last updated
- Sep 19, 2016
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | – | – | Yes |
| 207R00000X | Internal Medicine | – | – |
Practice location
1413 Highway 17 SSuite 1200
Surfside Beach, SC 29575-6040
Phone 843-631-4656
Mailing address
1413 Highway 17 SSuite 1200
Surfside Beach, SC 29575-6040
Phone 843-631-4656
Authorized official
Tina J Lester
Business Manager
8049397037
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