East Cooper Physician Group LLC
Internal Medicine, Sports Medicine in Mt Pleasant, SC. Organization (NPI-2).
NPI number1316708456
StatusActive
Last updated in NPPESFeb 9, 2024
Details
- NPI
- 1316708456
- Entity type
- Organization (NPI-2)
- Legal business name
- East Cooper Physician Group LLC
- Organization subpart
- No
- Enumeration date
- Jan 16, 2024
- Certification date
- Feb 9, 2024
- Last updated
- Feb 9, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207RS0010X | Internal Medicine, Sports Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – |
Other names
- Sports Medicine Specialists Of Charleston (Doing Business As)
Practice location
851 Leonard Fulghum Dr Ste 101Mt Pleasant, SC 29464-3793
Phone 843-971-9350 · Fax 843-971-9351
Mailing address
Po Box 37642Belfast, ME 04915-1218
Other practice locations
7 S Alliance Dr Ste 111b
Goose Creek, SC 29445-7296
Goose Creek, SC 29445-7296
Phone 843-971-9350 · Fax 843-971-9351
Authorized official
Doreatha Rogers
Rcs Manager
9803027992
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