Organization
PALMETTO AXON NEUROMONITORING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DON STOVALL JR. MD (PRESIDENT)
(843) 872-9623
Entity
Organization
Contact information
Practice address
1643 B SAVANNAH HWY, #304, CHARLESTON, SC 29407-2202
(843) 872-9623
Mailing address
1643 B SAVANNAH HWY, #304, CHARLESTON, SC 29407-2202
(843) 872-9623
Taxonomy
Speciality
Code
Description
License number
State
204R00000X
Electrodiagnostic Medicine Physician
—
—
2084N0400X
Neurology Physician
—
—
2084N0600X
Clinical Neurophysiology Physician
Primary
—
—
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
—
—
Other
Enumeration date
02/21/2017
Last updated
03/24/2017
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