Organization
CHARLESTON RADIOLOGISTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA HUDSON (CREDENTIALING COORDINATOR)
(843) 824-0606
Entity
Organization
Contact information
Practice address
1241 WOODLAND AVENUE, MOUNT PLEASANT, SC 29464
(843) 824-0606
(843) 824-0909
Mailing address
1241 WOODLAND AVENUE, MOUNT PLEASANT, SC 29464
(800) 922-0346
(843) 569-8542
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB0361
MEDICARE RAILROAD
—
05
—
GP2431
—
SC
Enumeration date
08/17/2006
Last updated
01/09/2014
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