Individual
GEORGE STRATOS TARASIDIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
169 ASHLEY AVE, ROOM 202, CHARLESTON, SC 29425-8905
(843) 792-1414
Mailing address
169 ASHLEY AVE, ROOM 202, CHARLESTON, SC 29425-8905
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
8797739-8905
UT
208600000X
Surgery Physician
LL 34682
SC
Other
Enumeration date
06/05/2012
Last updated
01/31/2017
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