Mims, Albert D

Mims, Albert D is an individual health care provider with primary practice located at 148 Sauls St , Lake City SC 29560-2631. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Mims, Albert D can be contacted via phone (843) 374-3621.

Contact Information

Primary practice address
148 Sauls St Lake City SC 29560-2631
Phone: (843) 374-3621
Fax: (843) 374-3624
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 9352 South Carolina

Profile Details

NPI number 1609972314
LBN Legal business name Mims, Albert D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 16th, 2006
Last updated Nov 19th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609972314 NPPES
South Carolina Other P011055604 RR PTAN
South Carolina MEDICAID 093525 RR PTAN

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