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General NPI Number Information
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NPI Number | 1043133382
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Entity Type | Organization
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Legal Business Name | THE HAVEN DIRECT PRIMARY CARE
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Dates
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Enumeration Date | 08/03/2026
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Last Update Date | 08/03/2026
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Provider Practice Location Address
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Address Line | 4708 OLEANDER DR STE 102
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5742
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Country | US
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Telephone | 843-213-5800
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Fax |
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Provider Business Mailing Address
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Address Line | 1489 BROOKGREEN DR
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City | MYRTLE BEACH
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State | SC
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Zip | 29577-5823
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Country | US
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Telephone | 843-213-5800
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTOPHER STANLEY
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Credential | MD
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Telephone | 352-408-9040
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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