Organization
DOMINIQUE BULTSMA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINIQUE BULTSMA MD (OWNER)
(843) 412-9012
Entity
Organization
Contact information
Practice address
1565 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4138
(843) 642-0074
Mailing address
1565 SAM RITTENBERG BLVD, CHARLESTON, SC 29407-4138
(843) 642-0074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
05/27/2025
Last updated
05/27/2025
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