Healthcare Provider Details

I. General information

NPI: 1720041700
Provider Name (Legal Business Name): PALMETTO PEDIATRICS OF THE LOWCOUNTRY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 OKATIE CENTER BLVD S SUITE 201
OKATIE SC
29909-7507
US

IV. Provider business mailing address

4 OKATIE CENTER BLVD S SUITE 201
OKATIE SC
29909-7507
US

V. Phone/Fax

Practice location:
  • Phone: 843-706-3206
  • Fax: 843-706-3226
Mailing address:
  • Phone: 843-706-3206
  • Fax: 843-706-3226

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: LANCE STEVEN LOWE
Title or Position: M.D.
Credential: M.D.
Phone: 843-706-3206