Organization
CHARLES J. NIVENS, MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. INGRID KRISTINE NIVENS (OFFICE MANAGER)
(843) 705-7471
Entity
Organization
Contact information
Practice address
3 PLANTATION PARK DR., BLUFFTON, SC 29910-4720
(843) 705-7471
(843) 705-7475
Mailing address
3 PLANTATION PARK DR., BLUFFTON, SC 29910-4720
(843) 705-7471
(843) 705-7475
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
18439
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
184393
—
SC
Enumeration date
12/01/2006
Last updated
12/31/2007
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