# MAGNOLIA ENDOCRINOLOGY, LLC

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

## Provider details

- **NPI number:** 1922639897
- **Authorized official:** TEMPLE MEWSHAW (OWNER)
- **Authorized official phone:** (854) 201-3636

## Contact information

- **Practice address:** 204 PARSONS RD, SUMMERVILLE, SC 29483-3348
- **Practice address phone:** (854) 201-3636
- **Mailing address:** 204 PARSONS RD, SUMMERVILLE, SC 29483-3348
- **Mailing address phone:** (854) 201-3636
- **Mailing address fax:** (854) 201-1983

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | NULL | Yes |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | — | — | Yes |

## Other

- **Enumeration date:** 01/30/2020
- **Last updated:** 01/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | K109 | — | SC |