Medical school: GEORGE WASHINGTON UNIVERSITY SCHOOL OF MEDICINE
Graduated: 1988
NPI: 1912917865
Practice Locations (3)
10 DOCTORS CIR, SUITE 2
Supply, NC 284624218
10 DOCTORS CIR, SUITE 2
SUPPLY, NC 284624218
9107556060
416 MAIN ST
NORTH MYRTLE BEACH, SC 295823024
9107556060
Source: CMS National Downloadable File, September 2026.