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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

TIDEWATER INTERNAL MEDICINE, LLC

Active Organization

TIDEWATER INTERNAL MEDICINE, LLC is a Primary Care Clinic organization located in CHARLESTON, South Carolina. NPI 1770510695 is currently active in the NPPES registry. Verify at CMS.

Primary Care Clinic · CHARLESTON, SC

Registration Details

NPI Number
1770510695
Provider Type
Organization
NPI Issued
Jun 27, 2006 (19.945231296758 yrs)
Last Updated
Oct 4, 2007
License
19466 (SC)

Practice Information

Address
2097 HENRY TECKLENBURG DR
SUITE 220
CHARLESTON, SC, 294145740
Browse SC providers · Browse ZIP 29414
Phone
8435716868
Fax
8435716198
Primary Specialty
Primary Care Clinic
261QP2300X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.