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Organization

TRIDENT ANESTHESIA GROUP, LLC

Active
Other names
Pain Care Physicians of Charleston, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
DR. RICHARD L FISHMAN M.D. (PARTNER/MEDICAL DIRECTOR)
(843) 414-1224
Entity
Organization

Contact information

Practice address
9263 MEDICAL PLAZA DR, STE B, CHARLESTON, SC 29406-7112
(843) 414-1224
(843) 414-1226
Mailing address
9263 MEDICAL PLAZA DR, SUITE E, CHARLESTON, SC 29406-7112
(843) 414-1224
(843) 414-1226

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP0090
SC
05
GP4750
SC
Enumeration date
09/18/2007
Last updated
07/19/2012
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