St Paul's Medical Group, INC

NPI #1740402130 in Hollywood, South Carolina

Provider Information

NPI Number: 1740402130
Entity Type: Organization
Organization Name: St Paul's Medical Group, INC
Primary Specialty: Clinic/Center
Enumeration Date: May 3, 2007
Last Updated: Dec 28, 2009

Practice Location

Address: 7610 HIGHWAY 164
City: Hollywood
State: South Carolina
ZIP Code: 29449
Phone: (843) 889-8018

Authorized Official

Name: MARSHA GAY DELAVAN, PA-C
Title: PRESIDENT
Phone: (843) 889-8018

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center	261Q00000X	Primary

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