Organization
CHARLESTON BREAST CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA F BARON MD (PRACTICE MANAGER)
(843) 556-0036
Entity
Organization
Contact information
Practice address
1930 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5837
(843) 556-0036
(843) 556-3844
Mailing address
1930 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5837
(843) 556-0036
(843) 556-3844
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
14926
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP4567
—
SC
Enumeration date
05/20/2006
Last updated
10/31/2007
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