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General NPI Number Information
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NPI Number | 1689945651
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Entity Type | Individual
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Provider Name | MARWAN AL ASWAD M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/23/2012
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Last Update Date | 09/28/2021
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Provider Practice Location Address
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Address Line | 4220 CAROLINA EXCHANGE DRIVE
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City | MYRTLE BEACH
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State | SC
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Zip | 29579-4220
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Country | US
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Telephone | 843-663-8000
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Fax | 843-663-8123
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Provider Business Mailing Address
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Address Line | PO BOX 547
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City | LITTLE RIVER
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State | SC
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Zip | 29566-0547
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Country | US
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Telephone | 843-663-8000
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Fax | 843-663-8123
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 37257
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License Number State | SC
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