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Individual

DANIELLE K. BAZEMORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2001 2ND AVE STE 201, SUMMERVILLE, SC 29486-7887
(843) 572-4840
(843) 764-2726
Mailing address
2015 2ND AVE STE 204, SUMMERVILLE, SC 29486-7889
(843) 793-6980

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3838
SC

Other

Enumeration date
11/23/2020
Last updated
09/03/2025
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