1487610119 NPI number — EDWARD J GIOVE DO

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487610119 NPI number — EDWARD J GIOVE DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIOVE
Provider First Name:
EDWARD
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1487610119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 13955
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLESTON
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29422-3955
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
843-225-8320
Provider Business Mailing Address Fax Number:
843-225-3549

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
297 SEVEN FARMS DR STE 202
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DANIEL ISLAND
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29492-7553
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-936-4470
Provider Business Practice Location Address Fax Number:
843-256-6877
Provider Enumeration Date:
04/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  0644 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: SC2315A634 . This is a "MEDICAR PIN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: H10180A634 . This is a "MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 080173979 . This is a "MEDICARE RAIL ROAD" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".
  • Identifier: 006442 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".
  • Identifier: H10180634 . This is a "MEDICARE PTAN" identifier , issued by the state of ( SC ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com