Individual
MANUEL AUGUSTO VALDEBRAN CANALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5500 FRONT ST STE 440, SUMMERVILLE, SC 29486-8137
(843) 985-3565
(843) 985-9389
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4383413
SC
Other
Enumeration date
11/26/2019
Last updated
12/12/2024
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