Healthcare Provider Details

I. General information

NPI: 1285679290
Provider Name (Legal Business Name): SUMTER EAR, NOSE, THROAT & FACIAL PLASTIC SURGERY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 N SUMTER ST SUITE 400
SUMTER SC
29150-4916
US

IV. Provider business mailing address

100 N SUMTER ST SUITE 400
SUMTER SC
29150-4916
US

V. Phone/Fax

Practice location:
  • Phone: 803-778-5970
  • Fax: 803-778-5403
Mailing address:
  • Phone: 803-778-5970
  • Fax: 803-778-5403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number
License Number State

VIII. Authorized Official

Name: DAVID BRIAN LOVICE
Title or Position: OWNER/PARTNER
Credential: MD
Phone: 803-778-5970