Organization
PELICAN II, LLC
Active
Other names
Imaging Specialists of Charleston
Organization subpart
No
Provider details
NPI number
Authorized official
LAURA HUDSON (CREDENTIALING COORDINATOR)
(843) 654-7229
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
(843) 824-0606
(843) 824-0909
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
—
—
2085N0700X
Neuroradiology Physician
—
—
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
2085R0204X
Vascular & Interventional Radiology Physician
—
—
2085U0001X
Diagnostic Ultrasound Physician
—
—
Other
Enumeration date
10/10/2006
Last updated
01/14/2014
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