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Organization
EDISTO MEDICINE
Active
Organization
EDISTO MEDICINE
Active
Other names
Edisto Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY DAWN RAKES-STEPHENS (MD)
(843) 217-1695
Entity
Organization
Contact information
Practice address
134 JUNGLE RD, EDISTO ISLAND, SC 29438-3005
(843) 897-7757
(843) 897-7877
Mailing address
134 JUNGLE RD, EDISTO ISLAND, SC 29438-3005
(843) 897-7757
(843) 897-7877
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17943
LICENSE
SC
Enumeration date
12/05/2025
Last updated
12/05/2025
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