Organization
MAGNOLIA DERMATOLOGY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH N MYERS JR. (OWNER)
(843) 769-2100
Entity
Organization
Contact information
Practice address
48 FOLLY ROAD BLVD, CHARLESTON, SC 29407-7507
(843) 769-2100
Mailing address
48 FOLLY ROAD BLVD, CHARLESTON, SC 29407-7507
(843) 769-2100
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
MD31744
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD31744
PROFESSIONAL LICENSE
SC
Enumeration date
04/08/2015
Last updated
04/17/2015
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