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General NPI Number Information
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NPI Number | 1528920253
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Entity Type | Organization
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Legal Business Name | EAST COOPER PHYSICIAN GROUP LLC
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Dates
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Enumeration Date | 12/01/2025
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Last Update Date | 12/01/2025
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Provider Practice Location Address
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Address Line | 406 BRIGHTON PARK BLVD STE 101
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City | SUMMERVILLE
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State | SC
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Zip | 29486-3056
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Country | US
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Telephone | 843-834-1879
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Fax |
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Provider Business Mailing Address
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Address Line | 880 ISLAND PARK DR UNIT 230
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City | DANIEL ISLAND
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State | SC
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Zip | 29492-2902
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | ENROLLMENT COORDINATOR
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Name | ABIGAIL KIRKLAND
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Credential |
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Telephone | 469-893-2695
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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