Basic Information
| Provider Information | |||||||||
| NPI: | 1568197234 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DANIEL ISLAND FAMILY MEDICINE LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 297 SEVEN FARMS DR STE 22 | ||||||||
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| City: | DANIEL ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294928720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8439364470 | ||||||||
| FaxNumber: | 8432566877 | ||||||||
| Practice Location | |||||||||
| Address1: | 297 SEVEN FARMS DR STE 22 | ||||||||
| Address2: | |||||||||
| City: | DANIEL ISLAND | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294928720 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8439364470 | ||||||||
| FaxNumber: | 8432566877 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/18/2022 | ||||||||
| LastUpdateDate: | 07/18/2022 | ||||||||
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| AuthorizedOfficialLastName: | GIOVE | ||||||||
| AuthorizedOfficialFirstName: | EDWARD | ||||||||
| AuthorizedOfficialMiddleName: | J | ||||||||
| AuthorizedOfficialTitleorPosition: | PHYSICIAN/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 8439364470 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | 07/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.