Organization
CHARLESTON BLOOD DISORDERS & CANCER CENTER, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT T WALL JR. M.D. (OWNER)
(843) 852-0266
Entity
Organization
Contact information
Practice address
2093 HENRY TECKLENBURG DRIVE SUITE318E, CHARLESTON, SC 29414
(843) 582-0266
(843) 852-2025
Mailing address
2093 HENRY TECKLENBURG DRIVE SUITE318E, CHARLESTON, SC 29414
(843) 582-0266
(843) 852-2025
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
20-11042
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3633
—
SC
Enumeration date
09/28/2006
Last updated
07/21/2010
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