Individual
DR. MICHAEL UGO ANTONUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
Primary
36833
SC
2085R0202X
Diagnostic Radiology Physician
36833
SC
2085R0202X
Diagnostic Radiology Physician
A120665
CA
Other
Enumeration date
11/09/2006
Last updated
03/12/2021
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