Individual
DR. CHARLES T CAMPBELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
12550
SC
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
12550
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
12550
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050028866
RR MEDICARE
SC
01
—
125509
SELECT HEALTH
SC
05
—
125509
—
SC
01
—
2000826
CCP
SC
01
—
4131521
AETNA
SC
01
—
77783
MEDCOST
SC
Enumeration date
10/27/2006
Last updated
10/15/2020
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