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1831154269

NPI Code Detail

MEDICARE: DR. ELIZABETH SOPER MD

MEDICARE: DR. ELIZABETH SOPER MD

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	207V00000X	Obstetrics & Gynecology Physician	01049975	IN
2	207V00000X	Obstetrics & Gynecology Physician	87889	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	:	1831154269
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ELIZABETH SOPER MD

Provider Business Mailing Address
First Line	:	PO BOX 421718
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29442-4203
Country	:	US
Telephone Number	:	843-527-7000
Fax Number	:

Provider Business Practice Location Address
First Line	:	4320 HOLMESTOWN RD
Second Line	:
City	:	MYRTLE BEACH
State	:	SC
Zip	:	29588-7837
Country	:	US
Telephone Number	:	843-546-3132
Fax Number	:	843-546-2268

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

Provider Enumeration Date	:	04/19/2006
Last Update Date	:	11/05/2025

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Directions to “ DR. ELIZABETH SOPER MD” Practice Location

Language	Start Address	Practice Location

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