Healthcare Provider Details

I. General information

NPI: 1205934692
Provider Name (Legal Business Name): DAUNIS ADELSA ABOABA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 12/06/2023
Certification Date: 12/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

IV. Provider business mailing address

1 PINCKNEY BLVD
BEAUFORT SC
29902-6122
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-5508
  • Fax: 843-228-2004
Mailing address:
  • Phone: 843-228-5508
  • Fax: 843-228-2004

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD36505
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: