MEDICARE: DR. NAZILA ESHRAGHI DPM

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E4566	CA
2	213E00000X	Podiatrist	718	SC

General Provider Information

NPI Number	:	1164454609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NAZILA ESHRAGHI DPM

Provider Business Mailing Address
First Line	:	5 EXECUTIVE CT # 102
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-9338
Country	:	US
Telephone Number	:	803-693-2425
Fax Number	:	833-989-2166

Provider Business Practice Location Address
First Line	:	5 EXECUTIVE CT # 102
Second Line	:
City	:	CLOVER
State	:	SC
Zip	:	29710-9338
Country	:	US
Telephone Number	:	803-693-2425
Fax Number	:	833-989-2166

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2006
Last Update Date	:	05/11/2026

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