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Organization

PRIMECARE FAMILY PRACTICE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ADEBOLA EDWARD ROJUGBOKAN MD (PHYSICIAN)
(843) 863-0777
Entity
Organization

Contact information

Practice address
145 ST JAMES AVE, GOOSE CREEK, SC 29445-2923
(843) 863-0777
(843) 824-6119
Mailing address
PO BOX 160, GOOSE CREEK, SC 29445-0160
(843) 863-0777
(843) 824-6119

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21082
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP3958
SC
Enumeration date
10/17/2007
Last updated
04/14/2008
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