Organization
LOWCOUNTRY CENTER FOR DIABETES & ENDOCRINOLOGY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. OLA S. BOLAND (OFFICE MANAGER)
(843) 538-8585
Entity
Organization
Contact information
Practice address
16 NORTHSIDE DR., WALTERBORO, SC 29488
(843) 538-8585
(843) 538-4777
Mailing address
16 NORTHSIDE DR., WALTERBORO, SC 29488
(843) 538-8585
(843) 538-4777
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20023
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
460002249
RAILROAD MEDICARE
SC
05
—
GP2198
—
SC
Enumeration date
02/28/2008
Last updated
04/09/2015
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