Individual
JONATHAN PUCHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333, CHARLESTON, SC 29414
(843) 792-2911
(843) 792-5265
Mailing address
169 ASHLEY AVENUE, ROOM 202 MAIN HOSPITAL MSC333, CHARLESTON, SC 29414
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
LL52725
SC
Other
Enumeration date
06/17/2018
Last updated
06/17/2018
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