Individual
DR. CHARLES RAST HUBBARD JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1519 MARION ST, COLUMBIA, SC 29201-2910
(803) 296-5954
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 522-8617
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
11963
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
119632
—
SC
Enumeration date
05/04/2006
Last updated
11/16/2020
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