Healthcare Provider Details
I. General information
NPI: 1053393876
Provider Name (Legal Business Name): STRAND PHYSICIAN SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/17/2005
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4591 SOCASTEE BLVD
MYRTLE BEACH SC
29588-7209
US
IV. Provider business mailing address
PO BOX 3439
NORTH MYRTLE BEACH SC
29582-0439
US
V. Phone/Fax
- Phone: 843-497-5929
- Fax: 843-293-1115
- Phone: 843-839-4447
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Y00000X |
| Taxonomy | Otolaryngology Physician |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208VP0014X |
| Taxonomy | Interventional Pain Medicine Physician |
| License Number | 24072 |
| License Number State | SC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 291U00000X |
| Taxonomy | Clinical Medical Laboratory |
| License Number | |
| License Number State | |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TARA
BROWN
Title or Position: HUMAN RESOURCES MANAGER
Credential:
Phone: 843-497-5929