Individual
STEPHEN P ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7510 N FOREST DR, CHARLESTON, SC 29420-4247
(843) 572-1600
(843) 572-1795
Mailing address
7510 N FOREST DR, CHARLESTON, SC 29420-4247
(843) 572-1600
(843) 572-1795
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
01047161A
IN
207Q00000X
Family Medicine Physician
Primary
89433
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01047161B
CSR
IN
01
—
DC3600
RAILROAD GROUP
IN
01
—
P00724943
RAILROAD INDIVIDUAL
IN
Enumeration date
08/10/2006
Last updated
06/29/2023
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