Provider Demographics
NPI:1356327167
Name:BULL, STEVEN F (MD)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:F
Last Name:BULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:8780 RIVERS AVE
Mailing Address - Street 2:SUITE 200, BUILDING B
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9257
Mailing Address - Country:US
Mailing Address - Phone:843-572-0810
Mailing Address - Fax:843-572-0817
Practice Address - Street 1:8780 RIVERS AVE
Practice Address - Street 2:SUITE 200, BUILDING B
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9257
Practice Address - Country:US
Practice Address - Phone:843-572-0810
Practice Address - Fax:843-572-0817
Is Sole Proprietor?:No
Enumeration Date:2005-12-22
Last Update Date:2011-11-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC9303207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC093035Medicaid
SC200066936OtherFIRST CHOICE
SC200066936OtherFIRST CHOICE
SCP00284270Medicare PIN
SCD17811Medicare UPIN