Healthcare Provider Details

I. General information

NPI: 1548204803
Provider Name (Legal Business Name): INTERNAL MEDICINE ASSOCIATES PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2006
Last Update Date: 09/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

805 PAMPLICO HWY SUITE B310
FLORENCE SC
29505-6047
US

IV. Provider business mailing address

805 PAMPLICO HWY SUITE B310
FLORENCE SC
29505-6047
US

V. Phone/Fax

Practice location:
  • Phone: 843-662-1516
  • Fax: 843-662-9830
Mailing address:
  • Phone: 843-662-1516
  • Fax: 843-662-9830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LLOYD CHARLES MILLER JR.
Title or Position: OWNER
Credential: MD
Phone: 843-662-1516