NPIMap

Organization Active NPI

Equilibrium Diabetes Center, LLC

  • Specialist
  • Charleston, SC
National Provider Identifier
1295156404
Registry record updated Dec 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
28953 Issued in SC
Legal business name
EQUILIBRIUM DIABETES CENTER, LLC
Practice address
1342 Ellison Run
Charleston, SC 29412-8285
Phone
(843) 364-6695
NPI assigned
Dec 16, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Orlin Sergev, MD
Title
President
Phone
(843) 871-7979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X SINGLE SPECIALTY GROUP 174400000X 28953 SC Primary

Addresses

Primary practice location

1342 Ellison Run
Charleston, SC 29412-8285

Mailing address

622 Old Trolley Rd
Suite 102
Summerville, SC 29485-5674
Phone (843) 871-7979

National Provider Directory

National Provider Directory

Locations

2831 Tricom St
North Charleston, SC 29406
Phone (803) 863-0088

103 Midland Pkwy a
Summerville, SC 29485
Phone (843) 871-7979

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1387152000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1387152000000",
    "number": "1295156404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "622 OLD TROLLEY RD",
            "address_2": "SUITE 102",
            "city": "SUMMERVILLE",
            "state": "SC",
            "postal_code": "294855674",
            "telephone_number": "843-871-7979",
            "fax_number": "843-871-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1342 ELLISON RUN",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294128285",
            "telephone_number": "843-364-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EQUILIBRIUM DIABETES CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-16",
        "last_updated": "2013-12-16",
        "status": "A",
        "authorized_official_last_name": "SERGEV",
        "authorized_official_first_name": "ORLIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-871-7979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "28953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.