Provider Demographics
NPI:1669675716
Name:LOWCOUNTRY HEMATOLOGY & ONCOLOGY, P.A.
Entity Type:Organization
Organization Name:LOWCOUNTRY HEMATOLOGY & ONCOLOGY, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MOHAMMAD
Authorized Official - Middle Name:DAUD
Authorized Official - Last Name:NAWABI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-881-5844
Mailing Address - Street 1:900 BOWMAN RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3218
Mailing Address - Country:US
Mailing Address - Phone:843-881-5844
Mailing Address - Fax:843-881-5012
Practice Address - Street 1:2048 CHARLIE HALL BLVD
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5830
Practice Address - Country:US
Practice Address - Phone:843-763-5104
Practice Address - Fax:843-763-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2009-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC25927174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3284Medicaid
SC7329Medicare ID - Type UnspecifiedMEDICARE GROUP NO.
SC3284Medicaid