Organization
WILDSTEIN SPINE CENTER, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL SCOTT WILDSTEIN M.D. (PRESIDENT)
(843) 406-2771
Entity
Organization
Contact information
Practice address
418 FOLLY RD, SUITE C, CHARLESTON, SC 29412-2625
(843) 406-2771
(843) 406-2789
Mailing address
1614 OCEAN NEIGHBORS BLVD, CHARLESTON, SC 29412-9647
(843) 406-2771
(843) 406-2789
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
24445
SC
Other
Enumeration date
12/18/2007
Last updated
01/13/2015
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