Individual
PAUL WILLIAM HALCZENKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
295 MIDLAND PKWY, SUMMERVILLE, SC 29485-8104
(843) 970-5255
Mailing address
1201 RAVEN RD, HANAHAN, SC 29410-8509
(321) 246-2705
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
01071583A
IN
2080P0203X
Pediatric Critical Care Medicine Physician
426479
PA
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
90515
SC
2080P0203X
Pediatric Critical Care Medicine Physician
ME158326
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001393000
—
FL
01
—
CH862Z
MEDICARE PTAN
FL
Enumeration date
07/08/2009
Last updated
08/01/2025
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