| Charleston Thyroid Center, Llc | |
|
1054 Johnnie Dodds Blvd Ste A Mount Pleasant SC 29464-3153 | |
| (843) 388-7545 | |
| (843) 388-5548 |
| Full Name | Charleston Thyroid Center, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1054 Johnnie Dodds Blvd Ste A, Mount Pleasant, South Carolina |
| Authorized Official Name and Position | Brittany Bohinc Henderson (OWNER/MD) |
| Authorized Official Contact | 8433887545 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Charleston Thyroid Center, Llc 1054 Johnnie Dodds Blvd Ste A Mount Pleasant SC 29464-3153 Ph: (843) 388-7545 | Charleston Thyroid Center, Llc 1054 Johnnie Dodds Blvd Ste A Mount Pleasant SC 29464-3153 Ph: (843) 388-7545 |
| NPI Number | 1548759780 |
|---|---|
| Provider Enumeration Date | 05/03/2018 |
| Last Update Date | 01/23/2019 |
| Medicare PECOS PAC ID | 2668726571 |
|---|---|
| Medicare Enrollment ID | O20181113000740 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548759780 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Lindsey Tucker |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346899671 PECOS PAC ID: 2769818616 Enrollment ID: I20200212002230 |
| Provider Name | Samantha E Allnutt |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487176046 PECOS PAC ID: 8123392487 Enrollment ID: I20201028001396 |
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