Proctor, Edward L

Proctor, Edward L is an individual health care provider with primary practice located at 923 Medical Cir , Myrtle Beach SC 29572-4116. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Forensic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Proctor, Edward L can be contacted via phone (843) 503-5442.

Contact Information

Primary practice address
923 Medical Cir Myrtle Beach SC 29572-4116
Phone: (843) 503-5442
Fax: (843) 449-6213
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Forensic Pathology 207ZF0201X 10303 South Carolina
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 10303 South Carolina

Profile Details

NPI number 1316917362
LBN Legal business name Proctor, Edward L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2006
Last updated Jun 6th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1316917362 NPPES
North Carolina MEDICAID 890659V
North Carolina MEDICAID 103033

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