Individual
ALLIE EBERLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8905
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
84082
SC
2085R0202X
Diagnostic Radiology Physician
Primary
LL84082
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2017
Last updated
06/11/2024
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