Grand Strand Pediatrics & Adolescent Medicine, P.a.
Pediatric Adolescent Medicine
Grand Strand Pediatrics & Adolescent Medicine, P.a. is a Myrtle Beach, South Carolina based Pediatric center with medical specialization in
Pediatric Adolescent Medicine.
It is located at
8120 Rourk St, Myrtle Beach, South Carolina - 29572-4127. They can be contacted on phone at
843-449-1438 and fax number 843-286-1349.
NPI number (Unique professional ID) for Grand Strand Pediatrics & Adolescent Medicine, P.a. is
1588614192 which was assigned by NPPES on 12 May, 2006 and it was last updated on 25 Feb, 2014.
Grand Strand Pediatrics & Adolescent Medicine, P.a. license number is
7085 for Pediatrics Adolescent Medicine (2080A0000X) in South Carolina.
Grand Strand Pediatrics & Adolescent Medicine, P.a. specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
Complete Profile:
Grand Strand Pediatrics & Adolescent Medicine, P.a. basic information including their official name, gender, specialization, credentials etc. are as mentioned below.
| Specialization : | Pediatrics Adolescent Medicine |
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| Provider Name : | Grand Strand Pediatrics & Adolescent Medicine, P.a. |
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Business Address:
Grand Strand Pediatrics & Adolescent Medicine, P.a. address, contact phone number and fax are as below. Patients can directly walkin to the clinic or can call on the below given phone number for appointment.
| Primary Address : | 8120 Rourk St
Myrtle Beach, SC, 29572-4127
United States |
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| Phone Number : | 843-449-1438 |
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| Fax Number : | 843-286-1349 |
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Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). NPI details are as mentioned below.
| NPI Number : | 1588614192 |
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| NPI Entity Type : | Organization |
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| First Enrolment Date : | 12 May, 2006 |
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| Last Updated On : | 25 Feb, 2014 |
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Authorized Official Details:
Officially authorized person to contact for any management issues or complaints of this organization are as below. Person's position and contact details are as mentioned below.
| Authorized Official Name : | Thomasw Petrusick |
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| Authorized Official Credential : | MD |
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| Official Title or Position : | OWNER/PHYSICIAN |
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| Phone Number : | 843-449-1438 |
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Licenses and Specialities:
Physicians/Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Grand Strand Pediatrics & Adolescent Medicine, P.a. are as mentioned. Primary taxonomy code for Grand Strand Pediatrics & Adolescent Medicine, P.a. is
2080A0000X (Pediatrics Adolescent Medicine).
| Taxonomy Code | Speciality | Primary | License No. | State |
|---|
| 2080A0000X | Pediatrics Adolescent Medicine | Yes | 7085 | SC |
Legacy Identifiers:
Other legacy medical identifiers of Grand Strand Pediatrics & Adolescent Medicine, P.a. such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned below.
| Identifier | Identifier Type | State | Issuer |
|---|
| ========= | Other | SC | FED ID# |
Mailing Address:
Mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned business address only.
| Mailing Address : | 8120 Rourk St
Myrtle Beach, SC, 29572-4127
United States |
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| Phone Number : | 843-449-1438 |
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| Fax Number : | 843-286-1349 |
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Business Location:
Patients can refer following map for directions to
Grand Strand Pediatrics & Adolescent Medicine, P.a. practice address. Don't forget to take prior appointment before visiting.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES.