Provider Demographics
NPI:1295793081
Name:ZIEMINICK, SHERI SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:SHERI
Middle Name:SCOTT
Last Name:ZIEMINICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:1156 BOWMAN RD
Practice Address - Street 2:STE 105
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-971-1233
Practice Address - Fax:843-971-1224
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2015-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC17566208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC175660Medicaid
SC571020809025OtherBCBS SC
SC6795Medicare ID - Type Unspecified
SC175660Medicaid