Individual
MITCHELL HAVERSTUHL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DNAP
Contact information
Practice address
9263 MEDICAL PLAZA DR STE E, CHARLESTON, SC 29406-7112
(843) 572-1228
Mailing address
1617 DOTTERERS RUN, CHARLESTON, SC 29414-5820
(219) 393-0469
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
239047
IN
367500000X
Certified Registered Nurse Anesthetist
Primary
148290
SC
Other
Enumeration date
07/25/2023
Last updated
05/20/2024
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