Individual
DR. R. BLAKE DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1106 CHUCK DAWLEY BLVD, SUITE 100, MOUNT PLEASANT, SC 29464-4183
(843) 849-1551
(843) 884-0629
Mailing address
1106 CHUCK DAWLEY BLVD, SUITE 100, MOUNT PLEASANT, SC 29464-4183
(843) 849-1551
(843) 884-0629
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
12163
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
DM0683
—
SC
05
—
GP2895
—
SC
Enumeration date
10/03/2005
Last updated
11/09/2009
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