Provider Demographics
NPI:1497816672
Name:PEE DEE OBGYN ASSOC., PA
Entity Type:Organization
Organization Name:PEE DEE OBGYN ASSOC., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:E
Authorized Official - Last Name:MURRAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-431-2740
Mailing Address - Street 1:2845 EAST HWY 76
Mailing Address - Street 2:MEDICAL PARK 2 SUITE 2
Mailing Address - City:MULLINS
Mailing Address - State:SC
Mailing Address - Zip Code:29574-6037
Mailing Address - Country:US
Mailing Address - Phone:843-431-2740
Mailing Address - Fax:843-431-2197
Practice Address - Street 1:2845 E HIGHWAY 76
Practice Address - Street 2:MEDICAL PARK 2 SUITE 2
Practice Address - City:MULLINS
Practice Address - State:SC
Practice Address - Zip Code:29574-6037
Practice Address - Country:US
Practice Address - Phone:843-431-2740
Practice Address - Fax:843-431-2197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8727207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC9630895OtherUNITED HEALTHCARE
NC02375OtherOFFICE IDENTIFIER
SCPA1872Medicaid
SC20000382OtherSELECT HEALTH
NC8902375OtherOFFICE IDENTIFIER
NC02375OtherOFFICE IDENTIFIER
SC20000382OtherSELECT HEALTH