Organization
PALMETTO ORTHO OF CHAS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WADDELL H GILMORE III M.D. (SENIOR PARTNER)
(843) 884-0302
Entity
Organization
Contact information
Practice address
180 WINGO WAY STE 301, MOUNT PLEASANT, SC 29464-1812
(843) 884-0302
(843) 849-9308
Mailing address
180 WINGO WAY STE 301, MOUNT PLEASANT, SC 29464-1812
(843) 884-0302
(843) 849-9308
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
9782
SC
335E00000X
Prosthetic/Orthotic Supplier
9782
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DM0683
—
SC
05
—
GP2895
—
SC
Enumeration date
06/24/2006
Last updated
05/16/2008
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