Individual
JARED M INTAPHAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9150 MEDCOM ST STE B, NORTH CHARLESTON, SC 29406
(843) 572-3330
Mailing address
9150 MEDCOM ST STE B, NORTH CHARLESTON, SC 29406
(843) 572-3330
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD39445
SC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD39445
SC
207RP1001X
Pulmonary Disease Physician
MD39445
SC
207RP1001X
Pulmonary Disease Physician
Primary
MD39455
SC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
MD39445
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
394451
—
SC
Enumeration date
09/03/2010
Last updated
10/03/2024
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