Healthcare Provider Details

I. General information

NPI: 1790198059
Provider Name (Legal Business Name): ZAINAB IQBAL MIAN M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/04/2014
Last Update Date: 09/26/2021
Certification Date: 09/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 BOWMAN RD
MT PLEASANT SC
29464-3213
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-724-2011
  • Fax: 843-606-7911
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number41005
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: