Individual
YVETTE-MARIE PELLEGRINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
BEAUFORT MEMORIAL LADY'S ISLAND INTERNAL MEDICINE, 117 SEA ISLAND PARKWAY, BEAUFORT, SC 29907-1500
(843) 522-7240
(843) 522-7249
Mailing address
955 RIBAUT RD, BMAC CREDENTIALING, BEAUFORT, SC 29902-5441
(843) 522-7240
(844) 296-2253
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
200501189
NC
207QA0505X
Adult Medicine Physician
Primary
81574
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010724821
TAX ID #
NC
05
—
5902403
—
NC
01
—
81547
SC STATE MD LICENSE
SC
05
—
815470
—
SC
Enumeration date
02/09/2006
Last updated
01/24/2023
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