Provider Demographics
NPI:1952307753
Name:GELFAND, STEPHEN G (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:G
Last Name:GELFAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4237 RIVER HILLS DRIVE
Mailing Address - Street 2:SUITE 150
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29566
Mailing Address - Country:US
Mailing Address - Phone:843-281-2778
Mailing Address - Fax:843-281-2785
Practice Address - Street 1:4237 RIVER HILLS DR
Practice Address - Street 2:SUITE 150
Practice Address - City:LITTLE RIVER
Practice Address - State:SC
Practice Address - Zip Code:29566-6444
Practice Address - Country:US
Practice Address - Phone:843-281-2778
Practice Address - Fax:843-281-2785
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22140207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952307753Medicaid
SCGP3730Medicaid
SC141889020OtherFEDERAL TAX IDENTIFICATIO
NC1952307753Medicaid
SCSC62449167Medicare PIN