Provider Demographics
NPI:1962730085
Name:ROUNTREE, INDIA ASHTON MILLER (MD)
Entity type:Individual
Prefix:DR
First Name:INDIA
Middle Name:ASHTON MILLER
Last Name:ROUNTREE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:INDIA
Other - Middle Name:ASHTON
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:612 SEACOAST PKWY
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-8247
Mailing Address - Country:US
Mailing Address - Phone:843-881-4440
Mailing Address - Fax:843-884-8540
Practice Address - Street 1:612 SEACOAST PKWY
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-881-4440
Practice Address - Fax:843-884-8540
Is Sole Proprietor?:No
Enumeration Date:2009-12-01
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME136375207N00000X
SC40714207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology