Individual
CHARLES P. TOUSSAINT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
222 E MEDICAL LN STE 100&200, WEST COLUMBIA, SC 29169-4847
(803) 935-8410
(803) 936-7816
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036119356
IL
207T00000X
Neurological Surgery Physician
Primary
32405
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
324054
—
SC
01
—
AA51138946
MEDICARE PTAN
SC
Enumeration date
10/30/2007
Last updated
11/11/2020
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