Healthcare Provider Details

I. General information

NPI: 1669569513
Provider Name (Legal Business Name): RIMON FAWZY YOUSSEF MB.BS.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 01/02/2025
Certification Date: 01/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1995 SAINT MATTHEWS RD
ORANGEBURG SC
29118-2405
US

IV. Provider business mailing address

2214 OLD CHEROKEE RD
LEXINGTON SC
29072-9725
US

V. Phone/Fax

Practice location:
  • Phone: 803-928-5525
  • Fax:
Mailing address:
  • Phone: 803-520-9280
  • Fax: 803-520-5972

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number27884
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number27884
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: