MEDICARE: LOWCOUNTRY CARDIOLOGY ASSOCIATES, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number State
1	363AM0700X	Medical Physician Assistant	SC
2	363LF0000X	Family Nurse Practitioner	SC
3	207RC0000X	Cardiovascular Disease Physician	SC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4251	OTHER		MEDICARE GROUP #

Other Identifiers

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

General Provider Information

NPI Number	:	1740231935
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWCOUNTRY CARDIOLOGY ASSOCIATES, PA

Provider Business Mailing Address
First Line	:	4969 CENTRE POINTE DR
Second Line	:	SUITE 100
City	:	N CHARLESTON
State	:	SC
Zip	:	29418-6952
Country	:	US
Telephone Number	:	843-853-0250
Fax Number	:	843-723-4566

Provider Business Practice Location Address
First Line	:	4969 CENTRE POINTE DR
Second Line	:	SUITE 100
City	:	N CHARLESTON
State	:	SC
Zip	:	29418-6952
Country	:	US
Telephone Number	:	843-853-0250
Fax Number	:	843-723-4566

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KENNETH H HANGER JR.
Credential	:	M.D. FAAC
Telephone Number	:	843-853-0250

Provider Enumeration Date	:	05/13/2006
Last Update Date	:	10/10/2007

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