Healthcare Provider Details

I. General information

NPI: 1245729755
Provider Name (Legal Business Name): ABIGAIL ESCALANTE DY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/09/2018
Last Update Date: 08/06/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1113 PARK WEST BLVD
MOUNT PLEASANT SC
29466-7121
US

IV. Provider business mailing address

96 JONATHAN LUCAS STREET CSB 816; MSC 630
CHARLESTON SC
29425-8900
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-9200
  • Fax:
Mailing address:
  • Phone: 843-792-3167
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number52649
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: