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Contact Information

FORT SUMTER SURGICAL CLINIC
1230 HOSPITAL DR
SUITE A
MOUNT PLEASANT, SC29464-3251
 Phone: 843-971-4673
 Fax: 843-971-3355
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgery

208600000X 02 Physician/General Surgery
 

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
 

Vascular Surgery

2086S0129X 76 Physician/Peripheral Vascular Disease
Indicates primary specialty

NPI Profile & details for FORT SUMTER SURGICAL CLINIC · (Female)

NPI Number 1437322542
Status Active
Credentials
Entity Individual
Enumeration date 04/09/2008
Last updated 04/10/2008 - About 18 years ago
Sole proprietor 1 Not specified
Identifiers
  • SC License # 27394
  • SC Medicaid 273947
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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