Provider Demographics
NPI:1285824169
Name:LOWCOUNTRY MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:LOWCOUNTRY MEDICAL ASSOCIATES
Other - Org Name:JOHN'S ISLAND FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SHOEMAKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-937-8101
Mailing Address - Street 1:3546 MAYBANK HWY
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-4847
Mailing Address - Country:US
Mailing Address - Phone:843-559-8887
Mailing Address - Fax:
Practice Address - Street 1:3546 MAYBANK HWY
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-4847
Practice Address - Country:US
Practice Address - Phone:843-559-8887
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOWCOUNTRY MEDICAL ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC27054207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty