Waccamaw Gastroenterology, Pc

LBN: Waccamaw Gastroenterology, Pc
Waccamaw Gastroenterology, Pc is an health care organization with primary practice located at 1011 N Fraser St , Georgetown SC 29440-2848. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as the primary health care specialty. Waccamaw Gastroenterology, Pc can be contacted via phone (843) 527-3428, or through Ballou, Laurence Havens via phone (843) 527-3428.

Contact Information

Primary practice address
1011 N Fraser St Georgetown SC 29440-2848
Phone: (843) 527-3428
Fax: (843) 546-8216
Website:
Map and Directions
Authorized official contact:
Name: Ballou, Laurence Havens Doctor of Medicine (MD)
Phone: (843) 527-3428

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X

Profile Details

NPI number 1548213564
LBN Legal business name Waccamaw Gastroenterology, Pc
DBA Doing business as
Authorized official Ballou, Laurence Havens Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date May 19th, 2006
Last updated Feb 5th, 2008 - about 18 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548213564 NPPES
South Carolina MEDICAID GP1579

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