EDWARD L PROCTOR JR. (NPI# 1316917362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316917362 |
| Entity Type | Individual |
| Full Name | EDWARD L PROCTOR JR. |
| Credential | MD |
| Practice Address |
923 Medical Cir Myrtle Beach SC 29572-4116 |
| Practice Telephone | 8435035442 |
| Practice Fax Number | 8434496213 |
| Mailing Telephone | 8435035442 |
| Mailing Fax Number | 8434496213 |
| Enumeration Date | 2006-01-24 |
| Last Update Date | 2016-06-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207ZF0201X |
Pathology Specialization: Forensic Pathology |
10303 | SC | Allopathic & Osteopathic Physicians |
| Y | 207ZP0102X |
Pathology Specialization: Anatomic Pathology & Clinical Pathology |
10303 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NC | 890659V | 05 | |
| SC | 103033 | 05 |
| Street Address |
923 MEDICAL CIR |
| City | MYRTLE BEACH |
| State | SC |
| Zip Code | 29572-4116 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629684576 | Matthew David Zeuschner | Nurse Practitioner | 107 Woodwind Court, Myrtle Beach, SC 29572 | 2020-09-16 |
| 1578191789 | Julia Ruth Nelson | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center- Gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-04-01 |
| 1407484835 | Justin Schevers | Student in an Organized Health Care Education/Training Program | 802 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-31 |
| 1922636919 | Darian Michael Quigg | Student in an Organized Health Care Education/Training Program | 809 82nd Street Parkway, Myrtle Beach, SC 29572 | 2020-03-27 |
| 1881221141 | Jonathan Alden Bryan | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2020-03-26 |
| 1215575238 | Polaris Skin Diagnostics, LLC | Dermatology | 8170 Rourk Street, Suite 100, Myrtle Beach, SC 29572 | 2019-12-20 |
| 1700348711 | Five Star Rehabilitation and Wellness Services, LLC. | Clinic/Center | 9547 N Kings Hwy, Myrtle Beach, SC 29572 | 2019-04-01 |
| 1154882975 | Michael Kouandjio | Student in an Organized Health Care Education/Training Program | Grand Strand Medical Center-gme Office, 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-26 |
| 1154880102 | Dylan Chase Morgan | Internal Medicine | Grand Strand Medical Center - Gme Office, 809 82nd Pkwy, Myrtle Beach, SC 29572 | 2019-03-19 |
| 1710446828 | David Redding Kingery Jr. | Student in an Organized Health Care Education/Training Program | Gme Office 809 82nd Parkway, Myrtle Beach, SC 29572 | 2019-03-18 |
| Find all providers in zip 29572 | ||||
| Taxonomy Code | 207ZP0102X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pathology |
| Specialization | Anatomic Pathology & Clinical Pathology |
| A pathologist deals with the causes and nature of disease and contributes to diagnosis, prognosis and treatment through knowledge gained by the laboratory application of the biologic, chemical and physical sciences. A pathologist uses information gathered from the microscopic examination of tissue specimens, cells and body fluids, and from clinical laboratory tests on body fluids and secretions for the diagnosis, exclusion and monitoring of disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added, 7/1/2009: definition reformatted] Additional Resources: American Board of Pathology, 2007. http://www.abpath.org/ This taxonomy code identifies the combined anatomic pathology & clinical pathology route. Board certification for Medical Doctors (MDs) is provided by the American Board of Pathology. To acknowledge the diverse activities in the practice of pathology and to accommodate the interests of individuals wanting to enter the field, the ABP offers primary certification through the following three routes: combined anatomic pathology and clinical pathology, anatomic pathology only and clinical pathology only. Primary certification in anatomic pathology or clinical pathology may be combined with some of the subspecialty certifications. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144352428 | Brian Wesley Watson | Pathology | 809 82nd Pkwy, Myrtle Beach, SC 29572-4607 | 2007-03-12 |
| 1821060997 | Dunes Pathology, LLC | Pathology | 915 Medical Cir, Myrtle Beach, SC 29572-4116 | 2006-02-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932691094 | Yanna Ding | Pathology | 169 Ashley Avenue, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2018-06-05 |
| 1508203522 | Daniel Carl Skipper | Pathology | 805 Pamplico Hwy Ste B210, Florence, SC 29505 | 2013-05-31 |
| 1972732162 | Kalli Kole Faulkner | Pathology | 218 Children's Hospital, 171 Ashley Avenue. Msc 908, Charleston, SC 29464 | 2009-07-08 |
| 1023259660 | Raymond Leonard Krzyzaniak | Pathology | 402-b Singleton Ridge Road, Conway, SC 29526 | 2009-03-11 |
| 1932351764 | Kent J Newsom | Pathology | 1 Science Ct Ste 200, Professional Pathology Services, Columbia, SC 29203-9653 | 2008-10-10 |
| 1942409719 | Raford Porter Rogers IIi | Pathology | 165 Ashley Ave Ste 309, Charleston, SC 29425-8905 | 2007-07-12 |
| 1083734529 | Herbert Derman | Pathology | 28 Yorkshire Dr, Hilton Head, SC 29928-3368 | 2007-03-29 |
| 1316063944 | Johann Hertel | Pathology | 165 Ashley Avenue, Suite 337, Charleston, SC 29425 | 2007-03-22 |
| 1861575813 | Mary Kathleen Wren | Pathology | 171 Ashley Ave, Msc 908, Department of Pathology, Charleston, SC 29425-8905 | 2006-10-23 |
| 1629168679 | Danyel Bourgeois Mcevoy | Pathology | 4450 Leeds Pl W Ste A, N Charleston, SC 29405-8405 | 2006-10-13 |
| Find all providers with the same taxonomy | ||||
| City | MYRTLE BEACH |
| Zip Code | 29572 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.