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General NPI Number Information
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NPI Number | 1801831094
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Entity Type | Organization
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Legal Business Name | PREMIER INTERNAL MEDICINE, LLC
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Dates
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Enumeration Date | 06/19/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 9217 UNIVERSITY BLVD SUITE C-1-D
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9147
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Country | US
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Telephone | 843-797-1716
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Fax | 843-797-1964
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Provider Business Mailing Address
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Address Line | 9217 UNIVERSITY BLVD SUITE C-1-D
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-9147
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Country | US
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Telephone | 843-797-1716
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Fax | 843-797-1964
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | MORGAN A LOWRY
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Credential | MD
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Telephone | 843-797-1716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 23155
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License Number State | SC
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