Healthcare Provider Details

I. General information

NPI: 1952307753
Provider Name (Legal Business Name): STEPHEN G GELFAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 06/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4237 RIVER HILLS DR SUITE 150
LITTLE RIVER SC
29566-6444
US

IV. Provider business mailing address

4237 RIVER HILLS DRIVE SUITE 150
MYRTLE BEACH SC
29566
US

V. Phone/Fax

Practice location:
  • Phone: 843-281-2778
  • Fax: 843-281-2785
Mailing address:
  • Phone: 843-281-2778
  • Fax: 843-281-2785

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number22140
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: