WELLNESS BOUTIQUE LLC NPI 1497002901

NPI Information

  • NPI: 1497002901
  • Provider Name: WELLNESS BOUTIQUE LLC
  • Classification: Obstetrics & Gynecology - 207V00000X
  • Entity Type: Organization
  • Address: 107 W COLLEGE AVE
    HARTSVILLE, SC
    ZIP 29550
  • Phone: (843) 861-2726

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NPI Details

WELLNESS BOUTIQUE LLC is an obstetrics gynecology in Hartsville, SC. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. WELLNESS BOUTIQUE LLC NPI is 1497002901. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

107 W COLLEGE AVE
HARTSVILLE, SC
ZIP 29550-113
Phone: (843) 861-2726

The provider's authorized official is Mchelle S Quaye .
The authorized official title is Medical Director and has the following contact phone number (843) 861-2726.

The enumeration date for this NPI number is 8/14/2012 and was last updated on 9/13/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207V00000XObstetrics & Gynecology22891SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1H06257MEDICARE UPINSOUTH CAROLINA
228916MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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