Individual
CHARLES R TATUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 WILLIAM H. JOHNSON STREET, STE 500, FLORENCE, SC 29506-2772
(843) 777-7410
(843) 777-7440
Mailing address
PO BOX 3239, FLORENCE, SC 29502-3239
(843) 656-2227
(843) 656-2242
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
11105
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111051
—
SC
01
—
890609B
NC MEDICAID
NC
Enumeration date
02/06/2006
Last updated
02/22/2021
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