Individual
DORENDA MIMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4050 BRIDGE VIEW DR, STE 600, NORTH CHARLESTON, SC 29405-7488
(843) 953-2450
Mailing address
200 GOODSON RD, HARLEYVILLE, SC 29448-3351
(843) 462-7766
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
33429
SC
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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