Healthcare Provider Details

I. General information

NPI: 1023564937
Provider Name (Legal Business Name): ERICA DUNMEYER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2016
Last Update Date: 08/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 BRIDGE VIEW DR
CHARLESTON SC
29405-7488
US

IV. Provider business mailing address

5727 GEATHERS RD
HOLLYWOOD SC
29449-5724
US

V. Phone/Fax

Practice location:
  • Phone: 843-953-0038
  • Fax:
Mailing address:
  • Phone: 843-906-7966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number214216
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number214216
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: