EDISTO OBGYN PA – NPI #1467407155
Obstetrics & Gynecology

An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.

Health Care Provider Taxonomy Code for Obstetrics & Gynecology

EDISTO OBGYN PA is a provider located in ORANGEBURG, SC. NPPES has assigned the NPI number 1467407155 to EDISTO OBGYN PA on May 23, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 207V00000X from the Health Care Provider Taxonomy code set, which is classified as Obstetrics & Gynecology.

The NPI profile was previously updated about 18 years ago on Jan 09, 2008. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for EDISTO OBGYN PA below.

NPI Profile for
EDISTO OBGYN PA

NPI Number
1467407155
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
EDISTO OBGYN PA
Primary location
1175 COOK RD
SUITE 305
ORANGEBURG, SC 29118
Phone: (803) 536-9390 Fax: (803) 533-0911
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
JEROME DEGEN
PRESIDENT
Phone: (803) 536-9390
Updated
Identifiers

Identifiers for EDISTO OBGYN PA

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDSC070540
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207V00000X
- Obstetrics & Gynecology (Primary)		 SC 07054

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.