| Waccamaw Gastroenterology, Pc | |
|
1011 N Fraser St Georgetown SC 29440-2848 | |
| (843) 527-3428 | |
| (843) 546-8216 |
| Full Name | Waccamaw Gastroenterology, Pc |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 1011 N Fraser St, Georgetown, South Carolina |
| Authorized Official Name and Position | Laurence Havens Ballou (PARTNER) |
| Authorized Official Contact | 8435273428 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waccamaw Gastroenterology, Pc 1011 N Fraser St Georgetown SC 29440-2848 Ph: (843) 527-3428 | Waccamaw Gastroenterology, Pc 1011 N Fraser St Georgetown SC 29440-2848 Ph: (843) 527-3428 |
| NPI Number | 1548213564 |
|---|---|
| Provider Enumeration Date | 05/19/2006 |
| Last Update Date | 02/05/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548213564 | NPI | - | NPPES |
| GP1579 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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