Bultsma, Dominique Samarane

Bultsma, Dominique Samarane is an individual health care provider with primary practice located at 345 Freshfields Dr Ste J101 , Johns Island SC 29455-5443. She recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as her primary health care specialty. Bultsma, Dominique Samarane can be contacted via phone (843) 768-4800.

Contact Information

Primary practice address
345 Freshfields Dr Ste J101 Johns Island SC 29455-5443
Phone: (843) 768-4800
Fax: (843) 606-8039
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 90584 South Carolina
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X LL84222 South Carolina

Profile Details

NPI number 1033733704
LBN Legal business name Bultsma, Dominique Samarane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2020
Last updated Feb 23rd, 2026 - about 8 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033733704 NPPES
South Carolina MEDICAID 905846

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