| Lowcountry Medical Care, Llc | |
|
181 Bluffton Rd Bldg G101g102 Bluffton SC 29910-6221 | |
| (843) 757-5400 | |
| (843) 757-2240 |
| Full Name | Lowcountry Medical Care, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 181 Bluffton Rd Bldg G101g102, Bluffton, South Carolina |
| Authorized Official Name and Position | Michael K Mikkelson (OWNER PHYSICIAN) |
| Authorized Official Contact | 8437575400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lowcountry Medical Care, Llc Po Box 2599 Bluffton SC 29910 Ph: (843) 757-5400 | Lowcountry Medical Care, Llc 181 Bluffton Rd Bldg G101g102 Bluffton SC 29910-6221 Ph: (843) 757-5400 |
| NPI Number | 1467598920 |
|---|---|
| Provider Enumeration Date | 01/30/2007 |
| Last Update Date | 04/18/2013 |
| Medicare PECOS PAC ID | 7113050972 |
|---|---|
| Medicare Enrollment ID | O20100729000899 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467598920 | NPI | - | NPPES |
| 080023023 | Other | SC | RAILROAD MEDICARE PART B |
| GP0137 | Medicaid | SC | |
| 84894 | Other | SC | MEDCOST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 15315 (South Carolina) | Primary |
| Provider Name | Michael K Mikkelson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972561496 PECOS PAC ID: 4385784511 Enrollment ID: I20091221000243 |
| Provider Name | Anna M Wells Sharp |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1790019602 PECOS PAC ID: 2365578564 Enrollment ID: I20100326000631 |
| Provider Name | Susan E Hackman Quinty |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1962483016 PECOS PAC ID: 5092759381 Enrollment ID: I20120313000655 |
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