Healthcare Provider Details

I. General information

NPI: 1396325858
Provider Name (Legal Business Name): ABIGAIL LAUGHTER MARCOM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ABIGAIL LAUGHTER MD

II. Dates (important events)

Enumeration Date: 04/09/2021
Last Update Date: 07/15/2022
Certification Date: 07/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 GROVE RD
GREENVILLE SC
29605-4210
US

IV. Provider business mailing address

701 GROVE RD
GREENVILLE SC
29605-4210
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-7895
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL86022
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: