Healthcare Provider Details

I. General information

NPI: 1093397515
Provider Name (Legal Business Name): MEREDITH ELISE BERNHARD HERNANDEZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

955 RIBAUT RD
BEAUFORT SC
29902-5454
US

IV. Provider business mailing address

955 RIBAUT RD
BEAUFORT SC
29902-5454
US

V. Phone/Fax

Practice location:
  • Phone: 843-522-5200
  • Fax: 901-210-7014
Mailing address:
  • Phone: 843-522-5200
  • Fax: 901-210-7014

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License Number20-96668
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: