Individual
DR. MARIBEL RODRIGUEZ-SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2810 ASHLEY PHOSPHATE RD, SUITE A-6, NORTH CHARLESTON, SC 29418-6405
(843) 553-7744
(843) 553-7734
Mailing address
2810 ASHLEY PHOSPHATE RD, SUITE A-6, NORTH CHARLESTON, SC 29418-6405
(843) 553-7744
(843) 553-7734
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
1134
SC
208D00000X
General Practice Physician
Primary
1134
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
011347
—
SC
01
—
10167
SC PCF
SC
01
—
1134
STATE LICENSE NUMBER
SC
01
—
12706
BROAD CERTIFICATION
IL
01
—
42D1077950
CLIA
SC
05
—
GP4815
—
SC
01
—
JBM04730
JUA
SC
Enumeration date
08/19/2005
Last updated
09/17/2024
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