Provider Demographics
NPI:1447265996
Name:SLOTT, EDWIN F (MD)
Entity type:Individual
Prefix:
First Name:EDWIN
Middle Name:F
Last Name:SLOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9231 MEDICAL PLAZA DR STE E
Mailing Address - Street 2:
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9101
Mailing Address - Country:US
Mailing Address - Phone:843-572-7715
Mailing Address - Fax:843-572-8808
Practice Address - Street 1:9231 MEDICAL PLAZA DR STE E
Practice Address - Street 2:
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9101
Practice Address - Country:US
Practice Address - Phone:843-572-7715
Practice Address - Fax:843-572-8808
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC17041207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCN00322Medicaid
SCF532972987Medicare PIN
SCN00322Medicaid
SCF532975872Medicare ID - Type Unspecified
F53297Medicare UPIN
SC930124470Medicare PIN