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Contact Information

CONWAY PODIATRY CENTER PC
8020 MYRTLE TRACE DR
CONWAY, SC29526-8945
 Phone: 843-236-7170
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for CONWAY PODIATRY CENTER PC · (Female)

NPI # 1093794166
Status Active
Credentials
Entity Individual
Enumeration date 01/17/2006
Last updated 08/20/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • SC License # 568
  • SC Medicaid PD5684
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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