Provider Demographics
NPI:1285603845
Name:ADVANCED WOMEN'S CARE, PA
Entity type:Organization
Organization Name:ADVANCED WOMEN'S CARE, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:DAVIDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-662-2299
Mailing Address - Street 1:901 E CHEVES STREET
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506
Mailing Address - Country:US
Mailing Address - Phone:843-662-2299
Mailing Address - Fax:843-656-2001
Practice Address - Street 1:901 E CHEVES STREET
Practice Address - Street 2:SUITE 200
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506
Practice Address - Country:US
Practice Address - Phone:843-662-2299
Practice Address - Fax:843-656-2001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-16
Last Update Date:2013-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3098Medicaid
SC70113Medicare ID - Type UnspecifiedSC MEDICARE GROUP ID
SC7013Medicare UPIN