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NPI Code Detail

MEDICARE: PROF. DEREK NELSON PA MLS (ASCP)

MEDICARE: PROF. DEREK NELSON PA MLS (ASCP)
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
1246Q00000XPathology Specialist/TechnologistSC

General Provider Information

NPI Number : 1275476699
Entity Type Code : Individual
Provider Name (Legal Business Name) : PROF. DEREK NELSON PA MLS (ASCP)
Provider Business Mailing Address
First Line : 1324 HAMLIN PARK CIR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29466-7128
Country : US
Telephone Number : 740-408-4773
Fax Number :
Provider Business Practice Location Address
First Line : 171 ASHLEY AVE
Second Line :
City : CHARLESTON
State : SC
Zip : 29425-0100
Country : US
Telephone Number : 843-405-2416
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2026
Last Update Date : 04/10/2026

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