MEDICARE: DOCTORS CARE SC, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	208D00000X	General Practice Physician
2	207P00000X	Emergency Medicine Physician
3	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1295074276
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS CARE SC, PA

Provider Business Mailing Address
First Line	:	1818 HENDERSON ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29201-2619
Country	:	US
Telephone Number	:	803-758-2600
Fax Number	:	803-253-8896

Provider Business Practice Location Address
First Line	:	200 MIDDLEBURG DR
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29579-3408
Country	:	US
Telephone Number	:	843-903-6650
Fax Number	:	843-903-0758

Authorized Official
Title or Position	:	CHIEF MEDICAL OFFICER
Name	:	DR. SHELLEY JANSSEN
Credential	:	MD
Telephone Number	:	803-782-4278

Provider Enumeration Date	:	02/11/2013
Last Update Date	:	09/09/2020

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Directions to “DOCTORS CARE SC, PA ” Practice Location

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