South Carolina Podiatric Physicians and Surgeons Group, LLC

NPI #1659797140 in Myrtle Beach, South Carolina

Provider Information

NPI Number: 1659797140
Entity Type: Organization
Organization Name: South Carolina Podiatric Physicians and Surgeons Group, LLC
Primary Specialty: Podiatrist
Enumeration Date: Mar 9, 2014
Last Updated: Mar 9, 2014

Practice Location

Address: 8141 ROURK ST
City: Myrtle Beach
State: South Carolina
ZIP Code: 29572-4128
Phone: (843) 449-8079

Authorized Official

Name: BRANDON PERCIVAL
Title: PRESIDENT
Phone: (803) 285-1411

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Podiatrist - Foot & Ankle Surgery — Foot & Ankle Surgery	213ES0103X
Podiatrist - Foot Surgery — Foot Surgery	213ES0131X
Podiatrist	213E00000X	Primary

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