Individual
ISIS RAULINO SCOMACAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0001
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
57028959
OH
208200000X
Plastic Surgery Physician
Primary
84660
SC
Other
Enumeration date
11/02/2016
Last updated
10/23/2020
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