Waccamaw Cardiology PC

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

WACCAMAW CARDIOLOGY PC

Practice address

2376 Cypress Cir
Suite 102
Conway, SC 29526-8964

Phone

(843) 347-8953

Fax

(843) 347-0226

NPI assigned

Aug 24, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Andrew J. Gresko, MDNPI 1245231372

Title

Owner

Phone

(843) 347-8953

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Andrew J Gresko, MD

  • Clinical Cardiac Electrophysiology Physician
  • Conway, SC
  • NPI 1245231372

  Cardiovascular Disease

  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1013900125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 CYPRESS CIR",
            "address_2": "SUITE 102",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268964",
            "telephone_number": "843-347-8953",
            "fax_number": "843-347-0226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2376 CYPRESS CIR",
            "address_2": "SUITE 102",
            "city": "CONWAY",
            "state": "SC",
            "postal_code": "295268964",
            "telephone_number": "843-347-8953",
            "fax_number": "843-347-0226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW CARDIOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-24",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "GRESKO",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-347-8953",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3178",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brandi Elaine Vonbartheld, LPC
• Whitney Lee Vovou, M.S., LPC
• Alysia A. Vulgaris
• Amanda D. Vuppala, M.D.
• Srinivas Vuppala, MD
• Waccamaw Center for Mental Health
• Waccamaw Pediatric Dental Care, LLC
• Waccamaw Primary Care,LLC
• Waccamaws Health and Wellness Services LLC
• Wal-Mart Stores East LP

• Specialist in Conway, SC
• Providers in Conway, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.