Organization
MAGNOLIA ENDOCRINOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TEMPLE MEWSHAW (OWNER)
(854) 201-3636
Entity
Organization
Contact information
Practice address
204 PARSONS RD, SUMMERVILLE, SC 29483-3348
(854) 201-3636
Mailing address
204 PARSONS RD, SUMMERVILLE, SC 29483-3348
(854) 201-3636
(854) 201-1983
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
K109
—
SC
Enumeration date
01/30/2020
Last updated
01/21/2022
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