Individual
DR. MAURICIO BASTOS PEREIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8905
(843) 792-1414
(843) 792-0720
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
AL93116
SC
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
AL93116
SC
Other
Enumeration date
06/27/2023
Last updated
08/14/2024
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