MEDICARE: LOWCOUNTRY UROLOGY CLINICS, PA

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	332B00000X	Durable Medical Equipment & Medical Supplies	480	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	:	1477740835
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOWCOUNTRY UROLOGY CLINICS, PA

Provider Business Mailing Address
First Line	:	2687 LAKE PARK DR
Second Line	:	LOWCOUNTRY UROLOGY CLINICS PA
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-9100
Country	:	US
Telephone Number	:	843-725-4414
Fax Number	:

Provider Business Practice Location Address
First Line	:	1300 HOSPITAL DR STE 210
Second Line	:
City	:	MOUNT PLEASANT
State	:	SC
Zip	:	29464-3208
Country	:	US
Telephone Number	:	843-884-9646
Fax Number	:

Authorized Official
Title or Position	:	AO
Name	:	SCOTT BARRETT SELLINGER
Credential	:
Telephone Number	:	850-309-0400

Provider Enumeration Date	:	10/01/2007
Last Update Date	:	12/22/2025

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