Healthcare Provider Details

I. General information

NPI: 1720257983
Provider Name (Legal Business Name): INLET CARDIOPULMONARY & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 02/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1011 N FRASER ST
GEORGETOWN SC
29440-2848
US

IV. Provider business mailing address

PO BOX 1169
PAWLEYS ISLAND SC
29585-1169
US

V. Phone/Fax

Practice location:
  • Phone: 843-235-3131
  • Fax: 843-237-9646
Mailing address:
  • Phone: 843-235-3131
  • Fax: 843-237-9646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number StateSC
# 4
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: MRS. TRACI R HELMS
Title or Position: BUSINESS MANAGER
Credential:
Phone: 843-235-3131