501 Family Medical Center LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

24043 Issued in SC

Legal business name

501 FAMILY MEDICAL CENTER LLC

Practice address

1752 Highway 501
Myrtle Beach, SC 29577-9750

Phone

(843) 448-3050

Fax

(843) 448-5934

NPI assigned

Jan 18, 2006

Last updated

Jun 5, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ewa B. Marcinkowska, M.D.NPI 1710166053

Title

Physician Owner

Phone

(843) 448-3050

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ewa B Marcinkowska, M.D.

  • Family Medicine Physician
  • Myrtle Beach, SC
  • NPI 1710166053
  Authorized official Same address or phone

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

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433462400000",
    "number": "1508846593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1752 HIGHWAY 501",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295779750",
            "telephone_number": "843-448-3050",
            "fax_number": "843-448-5934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1752 HIGHWAY 501",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295779750",
            "telephone_number": "843-448-3050",
            "fax_number": "843-448-5934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "501 FAMILY MEDICAL CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-18",
        "last_updated": "2015-06-05",
        "status": "A",
        "authorized_official_last_name": "MARCINKOWSKA",
        "authorized_official_first_name": "EWA",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "843-448-3050",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "SC",
            "license": "24043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "LL3787",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2015; 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.