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Organization
CHARLESTON FACIAL PLASTIC SURGERY LLC
Active
Organization
CHARLESTON FACIAL PLASTIC SURGERY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID WASTSON RODWELL III M.D. (OWNER)
(843) 882-7181
Entity
Organization
Contact information
Practice address
67 BROAD ST, SUITE 200, CHARLESTON, SC 29401-2936
(843) 882-7181
Mailing address
281 E SHORE LN, CHARLESTON, SC 29407-5656
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
Primary
TL36529
SC
Other
Enumeration date
04/15/2014
Last updated
04/15/2014
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