Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 83430 | SC |
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | OS11407 | FL |
Y | 207Q00000X | Family Doctor | 83430 | SC |
N | 207Q00000X | Family Doctor | OS11407 | FL |
NPI | 1023310281 |
---|---|
Provider Name | Dr. Eileen M Conaway |
First Address | Myrtle Beach, SC 29588-7837 |
Second Address | Myrtle Beach, SC 29588-7837 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2010 |
Last Update Date | 29/10/2021 |