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General NPI Number Information
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NPI Number | 1558480764
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Entity Type | Individual
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Provider Name | DR. SANDRA REID BIGELOW
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 832 PINCKNEY ST.
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City | MCCLELLANVILLE
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State | SC
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Zip | 29458
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Country | US
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Telephone | 843-887-3763
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Fax | 843-887-4228
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Provider Business Mailing Address
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Address Line | PO BOX 9
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City | MC CLELLANVILLE
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State | SC
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Zip | 29458-0009
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Country | US
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Telephone | 843-887-3763
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Fax | 843-887-4228
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2205
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License Number State | SC
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