Healthcare Provider Details

I. General information

NPI: 1659938827
Provider Name (Legal Business Name): VINCENT M SOMAIO, MD, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2019
Last Update Date: 08/06/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

107 SEAGRASS STATION RD
BLUFFTON SC
29910-9549
US

IV. Provider business mailing address

107 SEAGRASS STATION RD
BLUFFTON SC
29910-9549
US

V. Phone/Fax

Practice location:
  • Phone: 843-836-8200
  • Fax: 843-836-8595
Mailing address:
  • Phone: 843-422-4413
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VINCENT M SOMAIO
Title or Position: OWNER, SOLE MEMBER
Credential: MD
Phone: 843-836-8200