Healthcare Provider Details
I. General information
NPI: 1508853698
Provider Name (Legal Business Name): STRAND PHYSICIAN SPECIALISTS, PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/04/2005
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
809 82ND PKWY
MYRTLE BEACH SC
29572-4607
US
IV. Provider business mailing address
PO BOX 3439
NORTH MYRTLE BEACH SC
29582-0439
US
V. Phone/Fax
- Phone: 843-497-5929
- Fax:
- Phone: 843-839-4447
- Fax: 843-399-0123
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RE0101X |
| Taxonomy | Endocrinology, Diabetes & Metabolism Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 363AM0700X |
| Taxonomy | Medical Physician Assistant |
| License Number | |
| License Number State | |
| # 5 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
THADDEUS
GOLDEN
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 843-497-5929