Healthcare Provider Details

I. General information

NPI: 1750173647
Provider Name (Legal Business Name): NOVANT HEALTH BUCKWALTER SURGERY CENTER, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 05/19/2025
Certification Date: 05/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 BUCKWALTER PLACE BLVD
BLUFFTON SC
29910-5150
US

IV. Provider business mailing address

2085 FRONTIS PLAZA BLVD FL 3
WINSTON SALEM NC
27103-5614
US

V. Phone/Fax

Practice location:
  • Phone: 843-784-8181
  • Fax:
Mailing address:
  • Phone: 336-277-8757
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JASON BERND
Title or Position: SVP & PRESIDENT SOUTH CAROLINA REGI
Credential:
Phone: 704-776-6195