MEDICARE: CHRISTOPHER JAMES EDENFIELD PA

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	363A00000X	Physician Assistant	2100	SC

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	:	1982023339
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JAMES EDENFIELD PA

Provider Business Mailing Address
First Line	:	1938 CHARLIE HALL BLVD UNIT B
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-6099
Country	:	US
Telephone Number	:	843-402-0227
Fax Number	:	843-402-0232

Provider Business Practice Location Address
First Line	:	1938 CHARLIE HALL BLVD UNIT B
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29414-6099
Country	:	US
Telephone Number	:	843-402-0227
Fax Number	:	843-402-0232

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2014
Last Update Date	:	09/24/2025

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