Provider Demographics
NPI:1164742441
Name:SAVAGE, ALICE JUNE (MD)
Entity Type:Individual
Prefix:DR
First Name:ALICE
Middle Name:JUNE
Last Name:SAVAGE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 SIGMA DR
Mailing Address - Street 2:STE 100
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-7715
Mailing Address - Country:US
Mailing Address - Phone:843-302-8840
Mailing Address - Fax:843-569-5882
Practice Address - Street 1:8091 RIVERS AVE
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9236
Practice Address - Country:US
Practice Address - Phone:843-572-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-09
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCMMD.32734LL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCP01210548OtherRR-MEDICARE
SC327346Medicaid
SC327346Medicaid