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Organization
LOWCOUNTRY MEDICAL CARE, LLC
Active
Organization
LOWCOUNTRY MEDICAL CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL K MIKKELSON MD (OWNER PHYSICIAN)
(843) 757-5400
Entity
Organization
Contact information
Practice address
181 BLUFFTON RD BLDG G101G102, BLUFFTON, SC 29910-6221
(843) 757-5400
(843) 757-2240
Mailing address
PO BOX 2599, BLUFFTON, SC 29910
(843) 757-5400
(843) 757-2240
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
15315
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080023023
RAILROAD MEDICARE PART B
SC
01
—
84894
MEDCOST
SC
05
—
GP0137
—
SC
Enumeration date
01/30/2007
Last updated
04/18/2013
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