Individual
LUCINA AVILA KIDD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
87 SPRINGVIEW LN, SUMMERVILLE, SC 29485-9077
(843) 876-7979
Mailing address
PO BOX 602108, CHARLOTTE, NC 28260-2108
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
94690
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68187823
—
CO
Enumeration date
05/22/2009
Last updated
11/19/2025
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