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Organization
PALMETTO SPINE & SPORTS MEDICINE, PA
Active
Organization
PALMETTO SPINE & SPORTS MEDICINE, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY MICHAEL ZGLESZEWSKI M.D. (PRESIDENT/PHYSICIAN)
(843) 573-9997
Entity
Organization
Contact information
Practice address
3030 ASHLEY TOWN CENTER DR, BLGD A-102, CHARLESTON, SC 29414-5664
(843) 573-9997
(843) 377-1446
Mailing address
3030 ASHLEY TOWN CENTER DR, BLGD A-102, CHARLESTON, SC 29414-5664
(843) 573-9997
(843) 377-1446
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3855
—
SC
Enumeration date
04/25/2006
Last updated
03/21/2011
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