Healthcare Provider Details

I. General information

NPI: 1649739533
Provider Name (Legal Business Name): AUSTIN ORRIE MCCREA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2019
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 SINGLETON RIDGE RD
CONWAY SC
29526-9142
US

IV. Provider business mailing address

300 SINGLETON RIDGE RD
CONWAY SC
29526-9142
US

V. Phone/Fax

Practice location:
  • Phone: 843-347-7111
  • Fax:
Mailing address:
  • Phone: 843-347-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberDO82172
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2086H0002X
TaxonomyHospice and Palliative Medicine (Surgery) Physician
License NumberDO82172
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO82172
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: