Healthcare Provider Details

I. General information

NPI: 1992766307
Provider Name (Legal Business Name): MARIE-MICHELE CONSTANT M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2006
Last Update Date: 07/26/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

940 HOLLY ST
ORANGEBURG SC
29115-4930
US

IV. Provider business mailing address

940 HOLLY ST
ORANGEBURG SC
29115-4930
US

V. Phone/Fax

Practice location:
  • Phone: 803-536-2725
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number93570
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: