Organization
CHARLESTON HEALTHSPAN INSTITUTE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN KADY WILSON M.D. (PRACTITIONER/OWNER)
(843) 442-8915
Entity
Organization
Contact information
Practice address
900 ISLAND PARK DR, SUITE 104, DANIEL ISLAND, SC 29492
(843) 375-6588
(843) 353-1610
Mailing address
900 ISLAND PARK DR, SUITE 110, DANIEL ISLAND, SC 29492
(843) 375-6588
(843) 353-1610
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T30464
—
SC
Enumeration date
08/04/2015
Last updated
08/04/2015
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