Healthcare Provider Details

I. General information

NPI: 1770661555
Provider Name (Legal Business Name): CHRISTOPHER MICHAEL CERALDI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: CHRISTOPHER MICHAEL CERALDI M.D., F.A.C.S.

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 W GREENWOOD ST STE 1
ABBEVILLE SC
29620-5727
US

IV. Provider business mailing address

901 W GREENWOOD ST STE 1
ABBEVILLE SC
29620-5727
US

V. Phone/Fax

Practice location:
  • Phone: 864-366-9681
  • Fax: 864-366-5600
Mailing address:
  • Phone: 864-366-9681
  • Fax: 864-366-5600

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number24871
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number24871
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: