MEDICARE: SARAH HARLAN ZOURZOUKIS

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	363LP2300X	Primary Care Nurse Practitioner	27676	SC

General Provider Information

NPI Number	:	1912604380
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH HARLAN ZOURZOUKIS

Provider Business Mailing Address
First Line	:	1601 GREENE ST
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29208-4001
Country	:	US
Telephone Number	:	803-777-7412
Fax Number	:

Provider Business Practice Location Address
First Line	:	8761 DORCHESTER RD STE 100
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-7320
Country	:	US
Telephone Number	:	843-767-3323
Fax Number	:

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

Provider Enumeration Date	:	02/15/2023
Last Update Date	:	11/15/2023

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