Individual
DR. ERIC CLINTON BASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
02002876A
IN
2085R0202X
Diagnostic Radiology Physician
03683
KY
2085R0202X
Diagnostic Radiology Physician
2295
TN
2085R0202X
Diagnostic Radiology Physician
Primary
37621
SC
2085R0202X
Diagnostic Radiology Physician
OP60653343
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LL37621
STATE LICENSE
SC
Enumeration date
02/14/2006
Last updated
01/13/2020
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