# MEDICAL UNIVERSITY HOSPITAL AUTHORITY

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

## Provider details

- **NPI number:** 1952452914
- **Authorized official:** KARYN RAE (DIRECTOR)
- **Authorized official phone:** (843) 876-1344

## Contact information

- **Practice address:** 171 ASHLEY AVE, CHARLESTON, SC 29425-8908
- **Practice address phone:** (843) 792-1414
- **Mailing address:** PO BOX 751514, CHARLOTTE, NC 28275-1514
- **Mailing address phone:** (843) 792-6200

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | — | NULL | Yes |
| 208000000X | Pediatrics Physician | — | — | Yes |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 01/16/2007
- **Last updated:** 11/30/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | DEC200 | — | SC |
| 05 | — | DRC002 | — | SC |