EQUILIBRIUM DIABETES CENTER, LLC (NPI# 1295156404) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295156404 |
| Entity Type | Organization |
| Organization Name | EQUILIBRIUM DIABETES CENTER, LLC |
| Practice Address |
1342 Ellison Run Charleston SC 29412-8285 |
| Mailing Address |
622 Old Trolley Rd Suite 102 Summerville SC 29485-5674 |
| Practice Telephone | 8433646695 |
| Mailing Telephone | 8438717979 |
| Mailing Fax Number | 8438718282 |
| Enumeration Date | 2013-12-16 |
| Last Update Date | 2013-12-16 |
| Authorized Official Name | DR. ORLIN SERGEV (PRESIDENT) |
| Authorized Official Telephone | 8438717979 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 28953 | SC | Other Service Providers |
| Street Address |
1342 ELLISON RUN |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29412-8285 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780219055 | Terra Rae Mchugh | Speech-Language Pathologist | 418 Folly Rd. Phc Rehab, Suite B, Charleston, SC 29412 | 2020-03-07 |
| 1437795747 | Brigitte Britt Huttemeyer | Nurse Practitioner | 678 Castle Pinckney Dr, Charleston, SC 29412 | 2019-11-21 |
| 1760956619 | Madison Culler, D.m.d., P.a. | Dentist | 211 Simmons Street, Mount Pleasant, SC 29412 | 2019-01-14 |
| 1366932717 | Harborview Speech Therapy, LLC | Speech-Language Pathologist | 783 Stebbins Street, Charleston, SC 29412 | 2018-05-11 |
| 1780193003 | Grace K Cotton | Speech-Language Pathologist | 1265 Marshview Dr, Charleston, SC 29412 | 2017-09-29 |
| 1639628449 | Matthew Husband | Occupational Therapist | 930 Folly Road, Suite B, Charleston, SC 29412 | 2016-09-22 |
| 1679941843 | Renee Poser | Pharmacist | 907 Folly Rd Suite A, James Island, SC 29412 | 2015-09-04 |
| 1508205717 | Amanda Marie Ashcraft | Dental Hygienist | 113 Wappoo Creek Drive Suite 5, James Island Dental Associates Pa, Charleston, SC 29412 | 2013-06-20 |
| 1104147818 | Glendolyn Harrison | Social Worker | 125e Wappoo Creek Drive, Suite 101e, Charleston, SC 29412 | 2010-06-16 |
| 1487986055 | Rachel E. Brunette | Physical Therapist | 418 B Folly Rd., Charleston, SC 29412 | 2010-02-08 |
| Find all providers in zip 29412 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992262257 | Marnie Rustemeyer | Specialist | 1306 Kanawha Blvd E Ste 1001306, Charleston, WV 25301-3000 | 2019-02-22 |
| 1801307483 | Stacy Phillips | Specialist | 3015 Scuba Dr, Charleston, SC 29414-5696 | 2017-10-23 |
| 1437535705 | Dr Elizabeth Eliza Castle | Specialist | 1527 Sam Rittenberg Blvd Ste 202, Charleston, SC 29407-4189 | 2015-08-10 |
| 1699170084 | Emma Chambers | Specialist | 2059 Wild Flower Ln, Charleston, SC 29414-6471 | 2014-10-28 |
| 1255689659 | Lindsay Cameron | Specialist | 1804 Huntington Dr, Charleston, SC 29407-3121 | 2012-08-16 |
| 1225304314 | R L Stephens Md Inc | Specialist | 331 Laidley St Ste 204, Charleston, WV 25301-1605 | 2012-03-22 |
| 1720313919 | Norman Frank Kinsey | Specialist | 1 Carriage Ln Ste B201, Charleston, SC 29407-6078 | 2009-10-06 |
| 1952540296 | Kenneth M Stabile | Specialist | 2065 Savannah Hwy, Suite C, Charleston, SC 29407-2225 | 2009-02-10 |
| 1356513550 | Claudia Vivot Welber | Specialist | 217 Calhoun St, Charleston, SC 29401-1313 | 2008-03-27 |
| 1659565471 | Winford Graves Gasperson | Specialist | 543 Wappoo Rd, Charleston, SC 29407-2223 | 2007-09-05 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29412 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.