Organization
CHARLESTON SURGICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STANLEY M. WILSON M.D. (PRACTICE FACILITATOR)
(843) 577-7550
Entity
Organization
Contact information
Practice address
125 DOUGHTY ST, SUITE 660, CHARLESTON, SC 29403-5736
(843) 577-7550
(843) 853-5588
Mailing address
125 DOUGHTY ST, SUITE 660, CHARLESTON, SC 29403-5736
(843) 577-7550
(843) 853-5588
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA7395
—
SC
Enumeration date
01/03/2007
Last updated
03/25/2009
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