Healthcare Provider Details

I. General information

NPI: 1447210349
Provider Name (Legal Business Name): ELIZABETH C ALBERTO AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2006
Last Update Date: 11/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 E 2ND NORTH ST
SUMMERVILLE SC
29483-6858
US

IV. Provider business mailing address

107 W 5TH NORTH ST
SUMMERVILLE SC
29483-6446
US

V. Phone/Fax

Practice location:
  • Phone: 843-871-9669
  • Fax: 843-871-8197
Mailing address:
  • Phone: 843-871-9669
  • Fax: 843-871-8197

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number3154
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: