Healthcare Provider Details

I. General information

NPI: 1619933868
Provider Name (Legal Business Name): NORTH STRAND OB/GYN, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3617 CASEY ST SUITE A
LORIS SC
29569-2981
US

IV. Provider business mailing address

3617 CASEY ST SUITE A
LORIS SC
29569-2981
US

V. Phone/Fax

Practice location:
  • Phone: 843-756-7090
  • Fax: 843-756-0043
Mailing address:
  • Phone: 843-756-7090
  • Fax: 843-756-0043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number17358
License Number StateSC

VIII. Authorized Official

Name: DR. CHRIS S MCCAULEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 843-756-7090