Provider Demographics
NPI:1609836287
Name:LOW COUNTRY WOMEN'S SPECIALISTS
Entity Type:Organization
Organization Name:LOW COUNTRY WOMEN'S SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:R
Authorized Official - Last Name:ACCETTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-797-3664
Mailing Address - Street 1:83 SPRINGVIEW LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29485-8154
Mailing Address - Country:US
Mailing Address - Phone:843-797-3664
Mailing Address - Fax:843-820-1007
Practice Address - Street 1:1801 2ND AVE
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-7908
Practice Address - Country:US
Practice Address - Phone:843-797-3664
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LOW COUNTRY WOMEN'S SPECIALISTS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-03-27
Last Update Date:2020-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2500Medicaid
SC6068Medicare ID - Type Unspecified