Healthcare Provider Details

I. General information

NPI: 1467428938
Provider Name (Legal Business Name): STEVEN MARC CREMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 06/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4022 POSTAL WAY
MYRTLE BEACH SC
29579
US

IV. Provider business mailing address

P.O. BOX 14340
SURFSIDE BEACH SC
29587
US

V. Phone/Fax

Practice location:
  • Phone: 843-236-9925
  • Fax: 843-236-6191
Mailing address:
  • Phone: 843-236-9925
  • Fax: 843-236-6191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number10754
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: