Individual
LAURA MAGNUSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-2222
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
01077813A
IN
207W00000X
Ophthalmology Physician
Primary
82865
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300004752
—
IN
Enumeration date
03/18/2013
Last updated
07/09/2019
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