Basic Information
| Provider Information | |||||||||
| NPI: | 1467576199 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DIBONA | ||||||||
| FirstName: | DEE | ||||||||
| MiddleName: | ELLEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 324 COINBOW DR | ||||||||
| Address2: | |||||||||
| City: | MOUNT PLEASANT | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294642503 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8439714157 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4115 DORCHESTER RD STE 100 | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294057501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435546737 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/19/2007 | ||||||||
| LastUpdateDate: | 10/07/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 17988 | SC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
No ID Information.