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Contact Information

SOUTHERN ORTHOPEDICS AND SPORTS MEDICINE, LLC
851 LEONARD FULGHUM BLVD
SUITE 101
MOUNT PLEASANT, SC29464-3787
 Phone: 843-971-9350
 Fax: 843-971-9351
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Sports Medicine

207PS0010X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SOUTHERN ORTHOPEDICS AND SPORTS MEDICINE LLC · (Female)

NPI Number 1053568428
Status Active
Credentials
Entity Individual
Enumeration date 08/27/2008
Last updated 06/23/2016 - About 10 years ago
Sole proprietor 1 Not specified
Identifiers
  • SC Medicaid GP5001
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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