Provider Demographics
NPI:1265442958
Name:EAST COOPER SURGICAL ASSOCIATES WILLIAM H STROUD JR
Entity Type:Organization
Organization Name:EAST COOPER SURGICAL ASSOCIATES WILLIAM H STROUD JR
Other - Org Name:EAST COOPER SURGICAL ASSOICATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL SURGEON
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:KHOURY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-884-2247
Mailing Address - Street 1:1240 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3251
Mailing Address - Country:US
Mailing Address - Phone:843-884-2247
Mailing Address - Fax:843-881-0653
Practice Address - Street 1:1240 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3251
Practice Address - Country:US
Practice Address - Phone:843-884-2247
Practice Address - Fax:843-881-0653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2193Medicare PIN