# CHARLESTON FACIAL PLASTIC SURGERY LLC

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

## Provider details

- **NPI number:** 1194144493
- **Authorized official:** DR. DAVID WASTSON RODWELL III M.D. (OWNER)
- **Authorized official phone:** (843) 882-7181

## Contact information

- **Practice address:** 67 BROAD ST, SUITE 200, CHARLESTON, SC 29401-2936
- **Practice address phone:** (843) 882-7181
- **Mailing address:** 281 E SHORE LN, CHARLESTON, SC 29407-5656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207YS0123X | Facial Plastic Surgery Physician | TL36529 | SC | Yes |

## Other

- **Enumeration date:** 04/15/2014
- **Last updated:** 04/15/2014