Individual
DR. DAVID S PETERSEIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
125 DOUGHTY ST, SUITE 690, CHARLESTON, SC 29403-5736
(843) 720-8490
(843) 727-3602
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
20706
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
780001477
RAILRAOD MEDICARE
SC
01
—
P00754301
RAILROAD MC ID-RSFPN
SC
05
—
T47811
—
SC
Enumeration date
04/12/2006
Last updated
11/02/2009
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