Provider Demographics
NPI:1235327230
Name:LOWCOUNTRY HEMATOLOGY & ONCOLOGY, PA
Entity Type:Organization
Organization Name:LOWCOUNTRY HEMATOLOGY & ONCOLOGY, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:DAUD
Authorized Official - Last Name:NAWABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-797-3555
Mailing Address - Street 1:900 BOWMAN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3203
Mailing Address - Country:US
Mailing Address - Phone:843-881-5844
Mailing Address - Fax:843-881-9499
Practice Address - Street 1:9313 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 204
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9155
Practice Address - Country:US
Practice Address - Phone:843-797-3555
Practice Address - Fax:843-797-2523
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWCOUNTRY HEMATOLOGY & ONCOLOGY, PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-10-04
Last Update Date:2009-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
4240780002Medicare NSC