TIDELANDS HEALTH VASCULAR SURGERY – NPI #1649944414
Surgery

A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart.

TIDELANDS HEALTH VASCULAR SURGERY is a surgeon located in MURRELLS INLET, SC. NPPES has assigned the NPI number 1649944414 to TIDELANDS HEALTH VASCULAR SURGERY on August 05, 2021. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “TIDELANDS HEALTH VASCULAR SURGERY” is a dba name, the actual legal business name for this organization is GEORGETOWN PHYSICIAN ASSOCIATES, LLC. According to the NPI Registry, there are 2 additional location(s) assigned to this provider which are listed below. The primary taxonomy selected by this provider is 2086S0129X from the Health Care Provider Taxonomy code set, which is classified as Surgery, specializing in Vascular Surgery

The NPI profile was previously updated about 5 years ago on Aug 19, 2021. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for TIDELANDS HEALTH VASCULAR SURGERY below.

NPI Profile for
GEORGETOWN PHYSICIAN ASSOCIATES, LLC

NPI Number
1649944414
Enumeration Date

(about 5 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
GEORGETOWN PHYSICIAN ASSOCIATES, LLC
Doing Business As (dba): TIDELANDS HEALTH VASCULAR SURGERY
Primary location
4040 HIGHWAY 17 UNIT 104
MURRELLS INLET, SC 29576-5098
Phone: (843) 652-8390 Fax: (843) 652-8325
2 Other location(s):
1014 Huger Dr
Georgetown, SC 29440-3322
Phone: (843) 652-8390
Fax: (843) 652-8399
2200 Crow Ln
Myrtle Beach, SC 29577-1663
Phone: (843) 652-8390
Fax: (843) 652-8399
Mailing address
PO BOX 421718
GEORGETOWN, SC 29442-4203
Phone: (843) 520-8883 Fax:
Organization Subpart
No
Authorized Official
ELIZABETH WARD
EVP & CFO
Phone: (843) 527-7102
Updated
Certification Date
Aug 19, 2021

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
2086S0129X
- Surgery / Vascular Surgery (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.