MEDICARE: EDMUND RHETT, JR., M.D., P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207VG0400X	Gynecology Physician	8257	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1104997261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EDMUND RHETT, JR., M.D., P.A.

Provider Business Mailing Address
First Line	:	1300 HOSPITAL DR STE 150
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3243
Country	:	US
Telephone Number	:	843-375-2210
Fax Number	:	843-375-2214

Provider Business Practice Location Address
First Line	:	1300 HOSPITAL DR STE 150
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3243
Country	:	US
Telephone Number	:	843-375-2210
Fax Number	:	843-375-2214

Authorized Official
Title or Position	:	PRESIDENT
Name	:	EDMUND RHETT JR.
Credential	:	M.D.
Telephone Number	:	843-375-2210

Provider Enumeration Date	:	11/12/2006
Last Update Date	:	05/01/2017

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