Provider Demographics
NPI:1376168328
Name:LOWCOUNTRY VEIN SPECIALISTS LLC
Entity Type:Organization
Organization Name:LOWCOUNTRY VEIN SPECIALISTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARL
Authorized Official - Middle Name:
Authorized Official - Last Name:HUBACH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-652-5344
Mailing Address - Street 1:4545 HIGHWAY 17
Mailing Address - Street 2:
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-5117
Mailing Address - Country:US
Mailing Address - Phone:843-652-5344
Mailing Address - Fax:843-652-0067
Practice Address - Street 1:4545 HIGHWAY 17
Practice Address - Street 2:
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-5117
Practice Address - Country:US
Practice Address - Phone:843-652-5344
Practice Address - Fax:843-652-0067
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-15
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebologyGroup - Single Specialty