| Organization Name: | BAMBERG EMERGENCY GROUP PC |
| NPI Number: | 1407012701 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | SYLVAN M WALLER (PRESIDENT) |
| Mailing Address: | 509 North St Bamberg |
| State: | SC US |
| Postal Code: | 290031330 |
| Phone Number: | 8032454321 |
| Fax Number: | |
| NPI Enumeration Date: | 08/06/2008 |
| NPI Last Update Date: | 09/17/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |