# LEGACY INTERNAL MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528345162
- **Authorized official:** DR. TINA M BOTELHO MD (PHYSICIAN/OWNER)
- **Authorized official phone:** (843) 606-9199

## Contact information

- **Practice address:** 550 LONG POINT RD STE 100, MOUNT PLEASANT, SC 29464-8000
- **Practice address phone:** (843) 606-9199
- **Practice address fax:** (843) 718-2858
- **Mailing address:** 550 LONG POINT RD STE 100, MOUNT PLEASANT, SC 29464-8000
- **Mailing address phone:** (843) 606-9199
- **Mailing address fax:** (843) 718-2858

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/10/2011
- **Last updated:** 04/15/2025