MEDICARE: EAST COOPER PHYSICIAN GROUP 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

General Provider Information

NPI Number	:	1861253981
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST COOPER PHYSICIAN GROUP LLC

Provider Business Mailing Address
First Line	:	PO BOX 604408
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-4408
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 ISLAND PARK DR UNIT 210
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-2902
Country	:	US
Telephone Number	:	843-380-9330
Fax Number	:	843-380-8212

Authorized Official
Title or Position	:	RCS MANAGER
Name	:	DOREATHA ROGERS
Credential	:
Telephone Number	:	980-302-7992

Provider Enumeration Date	:	01/16/2024
Last Update Date	:	02/28/2026

Similar Medicare Providers

1477121721 — DR. MATTHEW TIMOTHY MORAN MD
Practice Location Address:

880 ISLAND PARK DR UNIT 220
DANIEL ISLAND, SC
29492-2902

Practice Phone: 843-380-9330
Practice Fax:

1255192308 — EAST COOPER PHYSICIAN GROUP LLC
Practice Location Address:

880 ISLAND PARK DR UNIT 220
DANIEL ISLAND, SC
29492-2902

Practice Phone: 843-380-9330
Practice Fax: 843-380-8212

1972374601 — EAST COOPER PHYSICIAN GROUP LLC
Practice Location Address:

880 ISLAND PARK DR UNIT 200
DANIEL ISLAND, SC
29492-2902

Practice Phone: 843-856-1771
Practice Fax: 843-856-8788

1316708449 — EAST COOPER PHYSICIAN GROUP LLC
Practice Location Address:

880 ISLAND PARK DR UNIT 210
DANIEL ISLAND, SC
29492-2902

Practice Phone: 843-884-5133
Practice Fax: 843-849-3343

1255495644 — JOHN GARDNER INMAN MD
Practice Location Address:

880 ISLAND PARK DR UNIT 200
DANIEL ISLAND, SC
29492-2902

Practice Phone: 843-856-1771
Practice Fax: 843-856-8788

1124447370 — JAMIE SCHULTIS MARTH MD
Practice Location Address:

880 ISLAND PARK DR UNIT 220
DANIEL ISLAND, SC
29492-2902

Practice Phone: 843-936-5970
Practice Fax: 843-936-5971

Directions to “EAST COOPER PHYSICIAN GROUP LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.