Individual
LUANN AQUINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14 OKATIE CENTER BLVD S, SUITE 101, OKATIE, SC 29909-7506
(843) 836-3800
(843) 837-7428
Mailing address
14 OKATIE CENTER BLVD S, SUITE 101, OKATIE, SC 29909-7506
(843) 836-3800
(843) 837-7428
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
021580
SC
207R00000X
Internal Medicine Physician
045035
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000845633C
—
GA
01
—
10063403
AMERIGROUP
GA
05
—
215805
—
SC
01
—
349710
WELLCARE
GA
01
—
P00121486
RR MEDICARE
GA
Enumeration date
07/18/2006
Last updated
10/29/2014
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