Organization Name: | ADVANCED WOMENS CARE OF THE LOWCOUNTRY,PC |
NPI Number: | 1104047653 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TRACY A BLUSEWICZ (OWNER/PHYSICIAN) |
Mailing Address: | 8 Hospital Center Blvd Suite 150 Hilton Head Island |
State: | SC US |
Postal Code: | 29926 |
Phone Number: | 8433413996 |
Fax Number: | 8433413282 |
NPI Enumeration Date: | 05/01/2007 |
NPI Last Update Date: | 02/14/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 26583 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |