Individual
ELIZABETH WAGNER BOZEMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
800 E CHEVES ST STE 350, FLORENCE, SC 29506-2649
(843) 777-7555
(843) 777-7563
Mailing address
PO BOX 601743, CHARLOTTE, NC 28260-1743
(843) 777-7555
(843) 777-7102
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
272604
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
TL4813
—
SC
Enumeration date
04/21/2006
Last updated
05/07/2025
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