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Organization

CHARLESTON MEDICAL ASSOCIATES

Active
Parent organization
CHARLESTON MEDICAL ASSOCIATES
Other names
Generations Pediatrics and Internal Medicine
Organization subpart
Yes

Provider details

NPI number
Legal business name
CHARLESTON MEDICAL ASSOCIATES
Authorized official
DR. MATTHEW JUSTICE KORNEGAY MD (MANAGING PARTNER)
(843) 614-7953
Entity
Organization

Contact information

Practice address
1483 TOBIAS GADSON BLVD STE 101, CHARLESTON, SC 29407-4795
(843) 405-1110
Mailing address
1483 TOBIAS GADSON BLVD STE 101, CHARLESTON, SC 29407-4795
(843) 405-1110

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
311442
SC
Enumeration date
05/10/2018
Last updated
05/10/2018
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