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Individual

MS. NICOL L. MAYFIELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
110 NNPTC CIR, GOOSE CREEK, SC 29445-6314
(843) 794-6881
(843) 794-6041
Mailing address
1233 BLUE SKY LN, CHARLESTON, SC 29492-8158
(402) 312-6319
(607) 257-3972

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2148
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
SCH673J061
MEDICARE PTAN
SC
Enumeration date
05/10/2006
Last updated
05/07/2025
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