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Individual

DOLI ELIZABETH BIONDILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3617 CASEY ST, SUITE C, LORIS, SC 29569-2981
(843) 716-7911
(843) 716-7918
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 777-7042
(843) 777-7102

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
36148
SC
207RP1001X
Pulmonary Disease Physician
Primary
36148
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2050741
CIGNA
SC
01
267902
MEDCOST
SC
01
30155455
SELECT HEALTH
SC
05
361487
SC
01
5751014
AETNA
SC
01
P01218899
RAILROAD MEDICARE
SC
01
SC14298552
MEDICARE PTAN
SC
Enumeration date
08/10/2005
Last updated
02/01/2021
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