Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Tidewater Surgical Group, PA

Organization Surgery Physician · NPI 1598835639

Tidewater Surgical Group, PA is a Surgery Physician in North Charleston, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2831B Tricom St
North Charleston, SC 29406-9172
Phone: (843) 797-8880
Fax: (843) 797-8884
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Surgery Physician (primary) Taxonomy 208600000X · Licence G93021 (SC)

Record details

NPI number1598835639
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lorraine Tyler — Practice Administraot · (843) 797-8880
NPI enumeratedNovember 8, 2006
Last updated in NPPESAugust 22, 2020
Mailing address2831b Tricom St, North Charleston, SC 29406-9172

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