Individual
HAMID REZA BAHADORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3531 MARY ADER AVE STE A, CHARLESTON, SC 29414-5896
(843) 723-0202
Mailing address
3531 MARY ADER AVE STE A, CHARLESTON, SC 29414-5896
(843) 723-0202
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
LL24898
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0011
—
SC
01
—
LL24898
MEDICAL LICENSE
SC
Enumeration date
11/02/2006
Last updated
09/24/2020
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