| Consultorio Medico Latino | |
|
2810 Ashley Phosphate Rd Suite B4 North Charleston SC 29418 | |
| (843) 553-7744 | |
| (843) 553-7734 |
| Full Name | Consultorio Medico Latino |
|---|---|
| Speciality | Internal Medicine |
| Location | 2810 Ashley Phosphate Rd, North Charleston, South Carolina |
| Authorized Official Name and Position | Andres J Arias (OWNER) |
| Authorized Official Contact | 8435537744 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Consultorio Medico Latino 2810 Ashley Phosphate Rd Suite B4 North Charleston SC 29418 Ph: (843) 553-7744 | Consultorio Medico Latino 2810 Ashley Phosphate Rd Suite B4 North Charleston SC 29418 Ph: (843) 553-7744 |
| NPI Number | 1114126372 |
|---|---|
| Provider Enumeration Date | 07/17/2007 |
| Last Update Date | 07/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114126372 | NPI | - | NPPES |
| GP4928 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 22122 (South Carolina) | Primary |
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