Provider Demographics
NPI:1083058564
Name:CHERAW GENERAL PRACTICE & ORTHOPEDICS LLC
Entity Type:Organization
Organization Name:CHERAW GENERAL PRACTICE & ORTHOPEDICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FAROOQ
Authorized Official - Middle Name:
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-910-1415
Mailing Address - Street 1:715 S DOCTORS DR
Mailing Address - Street 2:STE F
Mailing Address - City:CHERAW
Mailing Address - State:SC
Mailing Address - Zip Code:29520-7113
Mailing Address - Country:US
Mailing Address - Phone:843-537-1111
Mailing Address - Fax:843-537-9393
Practice Address - Street 1:715 S DOCTORS DR
Practice Address - Street 2:STE F
Practice Address - City:CHERAW
Practice Address - State:SC
Practice Address - Zip Code:29520-7113
Practice Address - Country:US
Practice Address - Phone:843-537-1111
Practice Address - Fax:843-537-9393
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-26
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC7952207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty