Basic Information
| Provider Information | |||||||||
| NPI: | 1134378573 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | BEAUFORT COUNTY EMERGENCY PHYSICIANS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 861 SW 78TH AVE | ||||||||
| Address2: | # 100-B | ||||||||
| City: | PLANTATION | ||||||||
| State: | FL | ||||||||
| PostalCode: | 333243273 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8776935700 | ||||||||
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| Practice Location | |||||||||
| Address1: | 628 E 12TH ST | ||||||||
| Address2: | EMERGENCY DEPARTMENT | ||||||||
| City: | WASHINGTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278893409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8776935700 | ||||||||
| FaxNumber: | 9546256034 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2008 | ||||||||
| LastUpdateDate: | 09/10/2008 | ||||||||
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| AuthorizedOfficialLastName: | SCHILLINGER | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
| AuthorizedOfficialMiddleName: | S. | ||||||||
| AuthorizedOfficialTitleorPosition: | MANAGING MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 8776935700 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363L00000X | N | 193200000X MULTI-SPECIALTY GROUP | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 207P00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.