MEDICARE: LOWCOUNTRY MEDICAL ASSOCIATES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	207R00000X	Internal Medicine Physician	SC
2	208000000X	Pediatrics Physician	SC
3	207Q00000X	Family Medicine Physician	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518916568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWCOUNTRY MEDICAL ASSOCIATES

Provider Business Mailing Address
First Line	:	180 WINGO WAY
Second Line	:	STE 202
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-1810
Country	:	US
Telephone Number	:	843-937-8101
Fax Number	:	843-937-8107

Provider Business Practice Location Address
First Line	:	615 WESLEY DR
Second Line	:	STE 120
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7204
Country	:	US
Telephone Number	:	843-266-0900
Fax Number	:	843-266-0901

Authorized Official
Title or Position	:	COO
Name	:	MRS. LINDA C SHOEMAKER
Credential	:
Telephone Number	:	843-937-8101

Provider Enumeration Date	:	05/08/2006
Last Update Date	:	09/15/2008

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Directions to “LOWCOUNTRY MEDICAL ASSOCIATES ” Practice Location

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