NPI 1740216191

Loris Medical Center, PA

Organisation Family Medicine Physician Loris, SC

Practice location

Address: 3439 Casey St, Loris, SC 29569-2903
Phone: (843) 756-1582
Fax: (843) 756-2042

Authorised official

Name: Wanda Graham
Title: Practice Administrator
Phone: (843) 756-5300

Registered specialties

Family Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207Q00000X

Other Family Medicine providers in South Carolina →

Registry record

NPI: 1740216191
Entity type: Organization
NPI issued: 25 Jun 2006
Record last updated: 10 Sep 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.