Healthcare Provider Details
I. General information
NPI: 1326047176
Provider Name (Legal Business Name): HILTON HEAD EMERGENCY PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/14/2005
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
25 HOSPITAL CENTER BLVD
HILTON HEAD ISLAND SC
29926-2738
US
IV. Provider business mailing address
1643 NW 136TH AVE STE 100
SUNRISE FL
33323-2857
US
V. Phone/Fax
- Phone: 843-689-8281
- Fax: 843-681-6122
- Phone: 800-424-3672
- Fax: 954-377-3042
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | 1428725 |
| License Number State | SC |
VIII. Authorized Official
Name: DR.
DAVID
JOSEPH
ISTVAN
Title or Position: PRESIDENT
Credential: MD
Phone: 917-679-1675