Provider Demographics
NPI:1588740310
Name:RAWLS, DARLENE OXENDINE (MD)
Entity type:Individual
Prefix:DR
First Name:DARLENE
Middle Name:OXENDINE
Last Name:RAWLS
Suffix:
Gender:F
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:PO BOX 63
Mailing Address - Street 2:5 RED SUNSET LANE
Mailing Address - City:FOLLY BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29439-0063
Mailing Address - Country:US
Mailing Address - Phone:843-478-9335
Mailing Address - Fax:
Practice Address - Street 1:5 RED SUNSET LANE
Practice Address - Street 2:
Practice Address - City:FOLLY BEACH
Practice Address - State:SC
Practice Address - Zip Code:29439-0063
Practice Address - Country:US
Practice Address - Phone:843-588-0058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-27
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13427207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC13427-8Medicaid
SCE11231-#FACILITYMedicare ID - Type UnspecifiedMEDICARE
SC13427-8Medicaid