Individual
TYNE OLIVIA TYSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9330 MEDICAL PLAZA DR, CHARLESTON, SC 29406-9104
(843) 847-5621
Mailing address
2860 TRICOM ST, NORTH CHARLESTON, SC 29406-9333
(843) 847-5621
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/05/2022
Last updated
03/20/2023
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