Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Edisto OBGYN PA

Organization Obstetrics & Gynecology Physician · NPI 1467407155

Edisto OBGYN PA is an Obstetrics & Gynecology Physician in Orangeburg, South Carolina. Licensed in South Carolina. Registered with an NPI since 2006.

Licensed in
SC
In the registry since
2006
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1175 Cook Rd Ste 305
Orangeburg, SC 29118
Phone: (803) 536-9390
Fax: (803) 533-0911
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 07054 (SC)

Record details

NPI number1467407155
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jerome Degen — President · (803) 536-9390
NPI enumeratedMay 23, 2006
Last updated in NPPESJanuary 9, 2008
Mailing address1175 Cook Rd, Suite 305, Orangeburg, SC 29118

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