MEDICARE: DAVID W SEIGNIOUS MD LLC

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	207R00000X	Internal Medicine Physician	13235	SC

General Provider Information

NPI Number	:	1790996098
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID W SEIGNIOUS MD LLC

Provider Business Mailing Address
First Line	:	3312 MAYBANK HWY
Second Line	:	SUITE A
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-4818
Country	:	US
Telephone Number	:	843-557-1111
Fax Number	:	843-557-1050

Provider Business Practice Location Address
First Line	:	3312 MAYBANK HWY
Second Line	:	SUITE A
City	:	JOHNS ISLAND
State	:	SC
Zip	:	29455-4818
Country	:	US
Telephone Number	:	843-557-1111
Fax Number	:	843-557-1050

Authorized Official
Title or Position	:	OWNER
Name	:	DAVID SEIGNIOUS
Credential	:	MD
Telephone Number	:	843-557-1111

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	04/10/2012

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