Organization Active NPI

Waccamaw Oncology, PA

  • Hematology & Oncology Physician
  • Georgetown, SC
National Provider Identifier
1649239989
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
WACCAMAW ONCOLOGY, PA
Practice address
2405 N Fraser St
Georgetown, SC 29440-6410
Phone
(843) 545-7274
Fax
(843) 546-7353
NPI assigned
Mar 23, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Darren Eugene Mullins, M.D.NPI 1134189814
Title
Owner/President
Phone
(843) 545-7274

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

2405 N Fraser St
Georgetown, SC 29440-6410

Mailing address

2405 N Fraser St
Georgetown, SC 29440-6410
Phone (843) 545-7274

Other identifiers 1

IdentifierTypeStateIssuer
GP3475MedicaidSC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649239989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294406410",
            "telephone_number": "843-545-7274",
            "fax_number": "843-546-7353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 N FRASER ST",
            "city": "GEORGETOWN",
            "state": "SC",
            "postal_code": "294406410",
            "telephone_number": "843-545-7274",
            "fax_number": "843-546-7353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WACCAMAW ONCOLOGY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULLINS",
        "authorized_official_first_name": "DARREN",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "843-545-7274",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3475",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.