Provider Demographics
NPI:1881622819
Name:PEE DEE INTERNAL MEDICINE
Entity type:Organization
Organization Name:PEE DEE INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:H
Authorized Official - Last Name:DOCHERTY
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:843-667-8561
Mailing Address - Street 1:514 S DARGAN ST
Mailing Address - Street 2:SUITE G
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2552
Mailing Address - Country:US
Mailing Address - Phone:843-667-8561
Mailing Address - Fax:
Practice Address - Street 1:514 S DARGAN ST
Practice Address - Street 2:SUITE G
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2552
Practice Address - Country:US
Practice Address - Phone:843-667-8561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Multi-Specialty