Healthcare Provider Details

I. General information

NPI: 1346411923
Provider Name (Legal Business Name): LOWCOUNTRY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2008
Last Update Date: 03/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SPRINGHALL DR
GOOSE CREEK SC
29445-5335
US

IV. Provider business mailing address

180 WINGO WAY SUITE 105
MT PLEASANT SC
29464-1810
US

V. Phone/Fax

Practice location:
  • Phone: 843-266-2520
  • Fax: 843-553-4436
Mailing address:
  • Phone: 843-937-8101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateSC

VIII. Authorized Official

Name: LINDA SHOEMAKER
Title or Position: COO
Credential:
Phone: 843-937-8101