Individual
DR. BRAD WESLEY NEVILLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
173 ASHLEY AVE, ROOM 544 BSB, DIVISION OF ORAL PATHOLOGY, MUSC, CHARLESTON, SC 29425-5070
(843) 792-4495
(843) 792-3697
Mailing address
173 ASHLEY AVE, ROOM 544 BSB, DIVISION OF ORAL PATHOLOGY, MUSC, CHARLESTON, SC 29425-5070
(843) 792-4495
(843) 792-3697
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
2375
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002375
—
SC
Enumeration date
10/18/2006
Last updated
11/03/2011
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