Organization
MEDICAL UNIVERSITY OF SC
Active
Other names
Division of Oral Pathology
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRAD W. NEVILLE DDS (DIRECTOR OF DIVISION OF ORAL PATHOL)
(843) 792-4496
Entity
Organization
Contact information
Practice address
173 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-4495
(843) 792-3697
Mailing address
MSC 507 173 ASHLEY AVENUE, CHARLESTON, SC 29425-0001
(843) 792-4495
(843) 792-3697
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2375
—
SC
05
—
ZX0019
—
SC
Enumeration date
11/08/2010
Last updated
03/04/2020
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