Healthcare Provider Details

I. General information

NPI: 1083578462
Provider Name (Legal Business Name): MS. KIMBERLY MARIE SINGLETON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2025
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

845 HOUSTON NORTHCUTT BLVD
MT PLEASANT SC
29464-3446
US

IV. Provider business mailing address

1605 RIVER RD
MC CLELLANVILLE SC
29458-9544
US

V. Phone/Fax

Practice location:
  • Phone: 843-359-2712
  • Fax:
Mailing address:
  • Phone: 843-359-2712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Q00000X
TaxonomyPathology Specialist/Technologist
License NumberB9E4E3G5
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: