Healthcare Provider Details
I. General information
NPI: 1003947490
Provider Name (Legal Business Name): FITTS SURGICAL, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/08/2007
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2270 ASHLEY CROSSING DR SUITE 155
CHARLESTON SC
29414-5732
US
IV. Provider business mailing address
2270 ASHLEY CROSSING DR SUITE 155
CHARLESTON SC
29414-5732
US
V. Phone/Fax
- Phone: 843-266-5500
- Fax: 843-266-5505
- Phone: 843-266-5500
- Fax: 843-266-5505
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ROBERT
W
FITTS
Title or Position: OWNER
Credential: M.D.
Phone: 843-266-5500