Provider Demographics
NPI:1568218840
Name:AGRONT DAVO, LAILANY (MD)
Entity Type:Individual
Prefix:
First Name:LAILANY
Middle Name:
Last Name:AGRONT DAVO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 MIDLAND PKWY
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8104
Mailing Address - Country:US
Mailing Address - Phone:843-970-5810
Mailing Address - Fax:
Practice Address - Street 1:109 BURTON AVE STE A
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29485-8117
Practice Address - Country:US
Practice Address - Phone:843-970-5810
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-26
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program