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General NPI Number Information
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NPI Number | 1245785393
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Entity Type | Organization
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Legal Business Name | SELECT FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 08/18/2016
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 312 S MCQUEEN ST
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City | FLORENCE
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State | SC
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Zip | 29501-4723
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Country | US
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Telephone | 843-799-2978
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Fax | 843-799-2980
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Provider Business Mailing Address
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Address Line | 1937 W PALMETTO ST STE 131
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City | FLORENCE
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State | SC
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Zip | 29501-3916
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Country | US
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Telephone | 843-619-3599
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Fax | 843-619-3599
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Authorized Official
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Title or Position | OWNER
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Name | TRAESA BROWN
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Credential | MD
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Telephone | 843-619-3599
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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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