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Individual

JUSTIN TYLER RUNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633
Mailing address
2880 TRICOM ST, NORTH CHARLESTON, SC 29406-9171
(843) 797-5050
(843) 797-3633

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
PA 1842
SC
363AS0400X
Surgical Physician Assistant
Primary
PA 1842
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1874PA
SC
01
1902246077
ARCIS HEALTHCARE GROUP NPI
SC
01
D043
ARCIS HEALTHCARE GROUP MEDICARE PTAN
SC
01
DU4331
ARCIS HEALTHCARE GROUP RAILROAD MEDICARE PTAN
SC
01
GP6337
ARCIS HEALTHCARE GROUP MEDICAID NO.
SC
01
P01337423
RAILROAD MEDICARE PTAN
SC
Enumeration date
09/25/2012
Last updated
03/13/2020
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