MEDICARE: CARDIOLOGY ASSOCIATES OF CHARLESTON LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse
2	207RC0000X	Cardiovascular Disease Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	7181	OTHER	SC	MEDICARE-PTAN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053337626
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARDIOLOGY ASSOCIATES OF CHARLESTON LLC

Provider Business Mailing Address
First Line	:	615 WESLEY DR
Second Line	:	SUITE 320
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7204
Country	:	US
Telephone Number	:	843-571-2939
Fax Number	:	843-571-4686

Provider Business Practice Location Address
First Line	:	615 WESLEY DR
Second Line	:	SUITE 320
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7204
Country	:	US
Telephone Number	:	843-571-2939
Fax Number	:	843-571-4686

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. GREGORY MILLER
Credential	:	M.D.
Telephone Number	:	843-571-2939

Provider Enumeration Date	:	07/15/2006
Last Update Date	:	02/21/2013

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Directions to “CARDIOLOGY ASSOCIATES OF CHARLESTON LLC ” Practice Location

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