# CHARLESTON THYROID & ENDOCRINE SPECIALISTS LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194116707
- **Authorized official:** MS. LISSA C LARA (CEO)
- **Authorized official phone:** (843) 412-1590

## Contact information

- **Practice address:** 418 FOLLY RD, SUITE A, CHARLESTON, SC 29412-2625
- **Practice address phone:** (843) 789-6364
- **Mailing address:** 418 FOLLY RD, SUITE A, CHARLESTON, SC 29412-2625
- **Mailing address phone:** (843) 789-6364

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RE0101X | Endocrinology, Diabetes & Metabolism Physician | 36116 | SC | Yes |

## Other

- **Enumeration date:** 02/18/2015
- **Last updated:** 02/18/2015