Basic Information
| Provider Information | |||||||||
| NPI: | 1265492953 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COKER | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 11271 | ||||||||
| Address2: | |||||||||
| City: | BELFAST | ||||||||
| State: | ME | ||||||||
| PostalCode: | 049154003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8778481457 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1590 FREEDOM BLVD | ||||||||
| Address2: | STE. B | ||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295056071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436659581 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/25/2006 | ||||||||
| LastUpdateDate: | 01/06/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 7337 | SC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 4255293 | 01 | SC | AETNA | OTHER | 8905336 | 05 | NC | MEDICAID | E2869 | 01 | SC | MEDCOST | OTHER | 073379 | 05 | SC | MEDICAID | 470890494 | 01 | SC | STANDARD TAX ID | OTHER | 0700476 | 01 | SC | CAROLINA CARE PLAN | OTHER |