Healthcare Provider Details

I. General information

NPI: 1205891942
Provider Name (Legal Business Name): MICHAEL BRITTON REMINES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/18/2006
Last Update Date: 12/01/2020
Certification Date: 12/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 POSTAL WAY
MYRTLE BEACH SC
29579-3537
US

IV. Provider business mailing address

300 SINGLETON RIDGE RD ATTENTION PATIENT ACCOUNTING
CONWAY SC
29526-9142
US

V. Phone/Fax

Practice location:
  • Phone: 843-236-0000
  • Fax: 843-236-6191
Mailing address:
  • Phone: 843-234-6946
  • Fax: 843-234-8958

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number82992
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1955
License Number StateWV
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number82992
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: