| Organization Name: | PELICAN II, LLC |
| NPI Number: | 1871681445 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LAURA HUDSON (CREDENTIALING COORDINATOR) |
| Mailing Address: | 1241 Woodland Avenue Mount Pleasant |
| State: | SC US |
| Postal Code: | 29464 |
| Phone Number: | 8438240606 |
| Fax Number: | 8438240909 |
| NPI Enumeration Date: | 10/10/2006 |
| NPI Last Update Date: | 01/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085B0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Body Imaging |
| Taxonomy Definition: | A Radiology doctor of Osteopathy that specializes in Body Imaging. |