Provider Demographics
NPI:1962502211
Name:WHIRRETT, ELIZABETH T (MD)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:T
Last Name:WHIRRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:874 WHIPPLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8900
Mailing Address - Country:US
Mailing Address - Phone:843-884-2133
Mailing Address - Fax:843-849-9466
Practice Address - Street 1:874 WHIPPLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-8900
Practice Address - Country:US
Practice Address - Phone:843-884-2133
Practice Address - Fax:843-849-9466
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2014-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21948207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC219481Medicaid
SC276551Medicaid
SC276551Medicaid
SCH59795Medicare UPIN