Individual
OTIS EDWARD ENGELMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1101 OLD TROLLEY RD, STE. 100, SUMMERVILLE, SC 29485-5293
(843) 875-0400
(843) 871-6700
Mailing address
2418 NNPTC CIRCLE, GOOSE CREEK, SC 29445
(843) 577-5011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
8516
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
410013918
MEDICARE RAIL ROAD
SC
05
—
85160
—
SC
Enumeration date
04/21/2006
Last updated
07/21/2022
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