| South Carolina Neuro, Llc | |
|
29 Leinbach Drive D4 Charleston SC 29407-7086 | |
| (843) 509-6521 | |
| (843) 636-3406 |
| Full Name | South Carolina Neuro, Llc |
|---|---|
| Speciality | Clinical Neuropsychologist |
| Location | 29 Leinbach Drive, Charleston, South Carolina |
| Authorized Official Name and Position | William Howard Buddin (OWNER) |
| Authorized Official Contact | 8438605266 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Carolina Neuro, Llc 29 Leinbach Drive D4 Charleston SC 29407-7086 Ph: (843) 509-6521 | South Carolina Neuro, Llc 29 Leinbach Drive D4 Charleston SC 29407-7086 Ph: (843) 509-6521 |
| NPI Number | 1184132193 |
|---|---|
| Provider Enumeration Date | 01/12/2018 |
| Last Update Date | 01/19/2021 |
| Certification Date | 01/19/2021 |
| Medicare PECOS PAC ID | 2062761463 |
|---|---|
| Medicare Enrollment ID | O20180817002299 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184132193 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103G00000X | Clinical Neuropsychologist | (* (Not Available)) | Primary |
| Provider Name | William Howard Buddin |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1215375035 PECOS PAC ID: 2466695408 Enrollment ID: I20130823000657 |
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