TIDEWATER HEALTH PC (NPI# 1649773789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649773789 |
| Entity Type | Organization |
| Organization Name | TIDEWATER HEALTH PC |
| Other Organization Name | TIDEWATER HEALTH |
| Practice Address |
1435 Stuart Engals Blvd Ste 101 Mount Pleasant SC 29464-7312 |
| Practice Telephone | 8438005686 |
| Practice Fax Number | 8438005656 |
| Mailing Telephone | 8438005686 |
| Mailing Fax Number | 8438005656 |
| Enumeration Date | 2018-03-15 |
| Last Update Date | 2019-05-01 |
| Authorized Official Name | DR. DAVID L SMITH (PRESIDENT) |
| Authorized Official Telephone | 8438005686 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2300X |
Clinic/Center Specialization: Primary Care |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| AFC Urgent Care | Doing Business As Name - Organization |
| Tidewater Health | Doing Business As Name - Organization |
| Street Address |
1435 STUART ENGALS BLVD STE 101 |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29464-7312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710999750 | David L Smith | Family Medicine | 1435 Stuart Engals Blvd Ste 101, Mount Pleasant, SC 29464-7312 | 2006-08-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 261QP2300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Primary Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528561453 | Sea Island Medical Care | Clinic/Center | 2114 Highway 41, Suite 105, Mount Pleasant, SC 29466 | 2018-03-16 |
| 1982070595 | Titus County Hospital District | Clinic/Center | 1901 Mulberry Ave, Mount Pleasant, TX 75455-2369 | 2015-08-18 |
| 1497165724 | Titus County Hospital District | Clinic/Center | 2001 N Jefferson Ave Ste 204a, Mount Pleasant, TX 75455-2300 | 2014-05-08 |
| 1588917694 | Titus County Hospital District | Clinic/Center | 1610 S Jefferson Ave, Mount Pleasant, TX 75455 | 2012-10-26 |
| 1679910426 | Health First | Clinic/Center | 2863 N Highway 17, Mount Pleasant, SC 29466-8962 | 2013-06-03 |
| 1679712400 | Thomas E Goodrich Md Sc | Clinic/Center | 6015 Durand Ave, Suite 500, Mount Pleasant, WI 53406-5089 | 2009-02-18 |
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| 1447758032 | Crs Eyecare Services, Inc. | Clinic/Center | 112 Rutledge Ave Ste A, Charleston, SC 29401-1333 | 2018-01-29 |
| 1316477060 | Lake City Medical Associates 2017, LLC | Clinic/Center | 130 S Acline St, Lake City, SC 29560-2633 | 2017-06-15 |
| 1417483355 | New Beginnings Health Services | Clinic/Center | 176 Dermis Ave, Hardeeville, SC 29927-4161 | 2017-05-11 |
| 1669919007 | Hypertension and Diabetes Prevention and Treatment Center Inc | Clinic/Center | 1812 Malden Drive, Hdpt Center Inc, Florence, SC 29505-3128 | 2017-01-24 |
| 1093262511 | Quad/med, LLC | Clinic/Center | 224a Harbor Freight Rd, Dillon, SC 29536-8501 | 2016-09-01 |
| 1649623653 | Woods Bay Family Care LLC | Clinic/Center | 128 E Baker St, Olanta, SC 29114-9101 | 2016-07-14 |
| 1407202112 | Regional Health and Testing Center | Clinic/Center | 376 W Palmetto St, Florence, SC 29501-4418 | 2016-05-11 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29464 |
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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.