Individual
DIANA N MEDLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OD, MH, PDH
Contact information
Practice address
2070 SAM RITTENBERG BLVD STE 412, CHARLESTON, SC 29407-4605
(843) 556-8844
Mailing address
106 W SHIPYARD RD, MOUNT PLEASANT, SC 29464-6658
(843) 971-8030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
989
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DP9891
—
SC
Enumeration date
07/12/2006
Last updated
11/10/2009
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