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General NPI Number Information
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NPI Number | 1033393954
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Entity Type | Organization
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Legal Business Name | E FAMILY MEDICIN GRP
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Dates
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Enumeration Date | 12/27/2007
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Last Update Date | 03/04/2008
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Provider Practice Location Address
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Address Line | 295 CALHOUN ST
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City | CHARLESTON
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State | SC
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Zip | 29425-8904
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Country | US
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Telephone | 843-792-3064
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Fax | 843-792-3605
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Provider Business Mailing Address
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Address Line | 295 CALHOUN ST
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City | CHARLESTON
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State | SC
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Zip | 29425-8904
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Country | US
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Telephone | 843-792-8451
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Fax | 843-792-9081
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Authorized Official
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Title or Position | REGISTRANT
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Name | MR. PETER F EDWARDS
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Credential | MHSA,RPH
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Telephone | 843-792-8451
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 50000863
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License Number State | SC
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