Provider Demographics
NPI:1760110704
Name:PIERCE, DONNA M
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:M
Last Name:PIERCE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2205 SOUTHSIDE BLVD APT 18D
Mailing Address - Street 2:
Mailing Address - City:PORT ROYAL
Mailing Address - State:SC
Mailing Address - Zip Code:29935-1036
Mailing Address - Country:US
Mailing Address - Phone:843-694-1533
Mailing Address - Fax:855-536-0676
Practice Address - Street 1:11 ROBERT SMALLS PKWY STE I1013
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29906-4202
Practice Address - Country:US
Practice Address - Phone:843-694-1533
Practice Address - Fax:855-536-0676
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-09
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy