Tidewater Surgical Group, PA
NPI #1598835639 in North Charleston, South Carolina
Provider Information
- NPI Number
- 1598835639
- Entity Type
- Organization
- Organization Name
- Tidewater Surgical Group, PA
- Primary Specialty
- Surgery
- Enumeration Date
- Nov 8, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 2831B TRICOM ST
- City
- North Charleston
- State
- South Carolina
- ZIP Code
- 29406-9172
- Phone
- (843) 797-8880
Authorized Official
- Name
- MRS. LORRAINE VERONICA TYLER
- Title
- PRACTICE ADMINISTRAOT
- Phone
- (843) 797-8880
Specialties & Taxonomy Codes
| Specialty |
|---|
| Surgery |
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