Individual
AUSTIN PETERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
650 ELLIS OAK AVENUE, CHARLESTON, SC 29412
(843) 792-3451
Mailing address
169 ASHLEY AVENUE, ROOM 202, MSC 333, CHARLESTON, SC 29425
(843) 876-7080
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL92497
SC
Other
Enumeration date
06/22/2024
Last updated
06/22/2024
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