Individual
TIFFANY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4 CARRIAGE LN STE 200, CHARLESTON, SC 29407-6049
(843) 266-7573
Mailing address
4 CARRIAGE LN STE 200, CHARLESTON, SC 29407-6049
(843) 266-7573
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA5278
SC
Other
Enumeration date
10/01/2021
Last updated
02/15/2026
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