Healthcare Provider Details

I. General information

NPI: 1912989740
Provider Name (Legal Business Name): STRAND PHYSICIAN SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 ROBERTSON BLVD
WALTERBORO SC
29488-2787
US

IV. Provider business mailing address

4615 OLEANDER DR
MYRTLE BEACH SC
29577-5741
US

V. Phone/Fax

Practice location:
  • Phone: 843-497-5929
  • Fax: 843-497-9940
Mailing address:
  • Phone: 843-497-5929
  • Fax: 843-497-9940

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: KENNETH L DEHART
Title or Position: PRESIDENT
Credential: MD
Phone: 843-497-5929