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1 S Park Cir Ste 400 Charleston SC 29407-4636 | |
(843) 789-1651 | |
Not Available |
Full Name | |
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Speciality | Internal Medicine |
Location | 1 S Park Cir, Charleston, South Carolina |
Authorized Official Name and Position | Douglas Bowling (CEO RSFPN) |
Authorized Official Contact | 8437242903 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 751649 Charlotte NC 28275-1649 Ph: (843) 789-1620 | 1 S Park Cir Ste 400 Charleston SC 29407-4636 Ph: (843) 789-1651 |
NPI Number | 1154695617 |
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Provider Enumeration Date | 03/01/2012 |
Last Update Date | 03/27/2012 |
Identifier | Type | State | Issuer |
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1154695617 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | (South Carolina) | Primary |
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