Provider Demographics
NPI:1073714713
Name:LOWCOUNTRY GASTROENTEROLOGY ASSOCIATES, PA
Entity Type:Organization
Organization Name:LOWCOUNTRY GASTROENTEROLOGY ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SEVERNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-884-8500
Mailing Address - Street 1:1300 HOSPITAL DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3261
Mailing Address - Country:US
Mailing Address - Phone:843-884-5200
Mailing Address - Fax:
Practice Address - Street 1:1300 HOSPITAL DR
Practice Address - Street 2:SUITE 300
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3261
Practice Address - Country:US
Practice Address - Phone:843-884-5200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical