Provider Demographics
NPI:1750472908
Name:VALCOURT, YVROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:YVROSE
Middle Name:
Last Name:VALCOURT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:YVROSE
Other - Middle Name:
Other - Last Name:TOUSSAINT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:124 MEDICAL PARK DR
Mailing Address - Street 2:
Mailing Address - City:WALTERBORO
Mailing Address - State:SC
Mailing Address - Zip Code:29488-5719
Mailing Address - Country:US
Mailing Address - Phone:843-782-3636
Mailing Address - Fax:843-782-3269
Practice Address - Street 1:124 MEDICAL PARK DR
Practice Address - Street 2:
Practice Address - City:WALTERBORO
Practice Address - State:SC
Practice Address - Zip Code:29488-5719
Practice Address - Country:US
Practice Address - Phone:843-782-3636
Practice Address - Fax:843-782-3269
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2008-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC29352208000000X
GA058526208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG58526Medicaid