Individual
ANTONIO HERNANDEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 SPRINGHALL DR, GOOSE CREEK, SC 29445-5335
(843) 572-8201
(843) 797-8491
Mailing address
PO BOX 13955, CHARLESTON, SC 29422-3955
(843) 225-8320
(843) 225-3549
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
29572
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
295727
—
SC
Enumeration date
12/06/2005
Last updated
07/21/2022
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