Healthcare Provider Details

I. General information

NPI: 1578851234
Provider Name (Legal Business Name): LOW COUNTRY MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/15/2011
Last Update Date: 07/18/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1156 BOWMAN RD STE. 105
MT PLEASANT SC
29464-3803
US

IV. Provider business mailing address

1156 BOWMAN RD STE. 105
MT PLEASANT SC
29464-3803
US

V. Phone/Fax

Practice location:
  • Phone: 843-971-1233
  • Fax: 843-971-1224
Mailing address:
  • Phone: 843-971-1233
  • Fax: 843-971-1224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332900000X
TaxonomyNon-Pharmacy Dispensing Site
License Number
License Number State

VIII. Authorized Official

Name: SHERI ZIEMINICK
Title or Position: MD
Credential:
Phone: 843-971-1233