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117 North Highway 52 Unit 56 Moncks Corner SC 29461-0056 | |
| (843) 900-7098 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 117 North Highway 52, Moncks Corner, South Carolina |
| Authorized Official Name and Position | Kimberly Davis (CREDENTIALING SPECIALISTS) |
| Authorized Official Contact | 9123734385 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 56 Moncks Corner SC 29461-0056 Ph: (843) 900-7098 | 117 North Highway 52 Unit 56 Moncks Corner SC 29461-0056 Ph: (843) 900-7098 |
| NPI Number | 1144038274 |
|---|---|
| Provider Enumeration Date | 12/20/2024 |
| Last Update Date | 12/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144038274 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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