Individual
DR. ALISA NICOLE BLUMENTHALER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
DEPARTMENT OF SURGERY 30 COURTENAY DRIVE MSC 295, CHARLESTON, SC 29425-1810
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-1414
Taxonomy
Speciality
Code
Description
License number
State
2086X0206X
Surgical Oncology Physician
Primary
95272
SC
2086X0206X
Surgical Oncology Physician
A194546
CA
390200000X
Student in an Organized Health Care Education/Training Program
11019543A
IN
Other
Enumeration date
06/26/2017
Last updated
08/11/2025
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