Individual
DR. ALLISON MARIE LAKE KOEPKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
167 BLUFFTON RD STE G, BLUFFTON, SC 29910-6228
(843) 757-8663
(843) 815-3849
Mailing address
167 BLUFFTON RD STE G, BLUFFTON, SC 29910-6228
(843) 757-8663
(843) 815-3849
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
01063739A
IN
208000000X
Pediatrics Physician
Primary
MD89413
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200864200
—
IN
Enumeration date
05/07/2007
Last updated
05/04/2026
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