Provider Demographics
NPI:1134094576
Name:BARRIER ISLANDS FREE MEDICAL CLINIC
Entity type:Organization
Organization Name:BARRIER ISLANDS FREE MEDICAL CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:PETERSEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-266-9800
Mailing Address - Street 1:3226 MAYBANK HWY STE C
Mailing Address - Street 2:
Mailing Address - City:JOHNS ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29455-4860
Mailing Address - Country:US
Mailing Address - Phone:843-266-9800
Mailing Address - Fax:843-266-9801
Practice Address - Street 1:3226 MAYBANK HWY STE C
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-4860
Practice Address - Country:US
Practice Address - Phone:843-266-9800
Practice Address - Fax:843-266-9801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-07
Last Update Date:2025-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable