Provider Demographics
NPI:1164821104
Name:HILTON HEAD CARDIOLOGY, CONSULTANTS, LLC
Entity Type:Organization
Organization Name:HILTON HEAD CARDIOLOGY, CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:H
Authorized Official - Last Name:THELUSMOND
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-805-8322
Mailing Address - Street 1:25 HOSPITAL CENTER BLVD STE 309
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2739
Mailing Address - Country:US
Mailing Address - Phone:843-535-0666
Mailing Address - Fax:888-849-3996
Practice Address - Street 1:25 HOSPITAL CENTER BLVD STE 309
Practice Address - Street 2:
Practice Address - City:HILTON HEAD
Practice Address - State:SC
Practice Address - Zip Code:29926-2739
Practice Address - Country:US
Practice Address - Phone:843-535-0666
Practice Address - Fax:888-849-3996
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-15
Last Update Date:2017-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty