Provider Demographics
NPI:1932112604
Name:WARNER, AMY S (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:S
Last Name:WARNER
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:851 LEONARD FULGHUM BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3787
Mailing Address - Country:US
Mailing Address - Phone:843-884-5133
Mailing Address - Fax:843-849-3343
Practice Address - Street 1:851 LEONARD FULGHUM BLVD
Practice Address - Street 2:SUITE 201
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3787
Practice Address - Country:US
Practice Address - Phone:843-884-5133
Practice Address - Fax:843-849-3343
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2018-10-30
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Provider Licenses
StateLicense IDTaxonomies
SC23010174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC230100Medicaid
SC230100Medicaid