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Organization

THE COLORECTAL ENDOSURGERY INSTITUTE OF THE CAROLINAS

Active
Parent organization
GASTROINTESTINAL SURGICAL SPECIALISTS, LLC
Organization subpart
Yes

Provider details

NPI number
Legal business name
GASTROINTESTINAL SURGICAL SPECIALISTS, LLC
Authorized official
DR. RUDOLPH B RUSTIN M.D. (OWNER)
(843) 853-7730
Entity
Organization

Contact information

Practice address
1439 STUART ENGALS BLVD, SUITE 100, MT PLEASANT, SC 29464-3305
(843) 853-7730
(843) 722-8766
Mailing address
1439 STUART ENGALS BLVD, SUITE 100, MT PLEASANT, SC 29464-3305
(843) 853-7730
(843) 722-8766

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1760411896
PARENT ORGANIZATION NPI
SC
01
582454655
PARENT ORGANIZATION TAX ID
SC
Enumeration date
04/30/2008
Last updated
12/14/2012
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