Healthcare Provider Details

I. General information

NPI: 1912604380
Provider Name (Legal Business Name): SARAH HARLAN ZOURZOUKIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/15/2023
Last Update Date: 11/15/2023
Certification Date: 11/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8761 DORCHESTER RD STE 100
NORTH CHARLESTON SC
29420-7320
US

IV. Provider business mailing address

1601 GREENE ST
COLUMBIA SC
29208-4001
US

V. Phone/Fax

Practice location:
  • Phone: 843-767-3323
  • Fax:
Mailing address:
  • Phone: 803-777-7412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number27676
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: