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General NPI Number Information
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NPI Number | 1114341278
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Entity Type | Organization
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Legal Business Name | STRAND ENDOCRINOLOGY,LLC
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Dates
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Enumeration Date | 02/10/2014
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Last Update Date | 07/18/2014
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Provider Practice Location Address
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Address Line | 5046 HIGHWAY 17 BYP S SUITE 104
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City | MYRTLE BEACH
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State | SC
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Zip | 29588-4503
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Country | US
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Telephone | 843-293-9955
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Fax | 843-293-9977
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Provider Business Mailing Address
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Address Line | 5046 HIGHWAY 17 BYP S SUITE 104
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City | MYRTLE BEACH
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State | SC
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Zip | 29588-4503
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Country | US
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Telephone | 843-293-9955
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Fax | 843-293-9977
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JAVAID H WANI
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Credential | MD, PHD
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Telephone | 843-293-9955
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | MD32116
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License Number State | SC
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