Healthcare Provider Details

I. General information

NPI: 1093712101
Provider Name (Legal Business Name): DAVID J TABER PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 08/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MUSC DIVISION OF TRANSPLANT SURGERY 96 JONATHAN LUCAS ST; CSB 409
CHARLESTON SC
29425-0001
US

IV. Provider business mailing address

318 COMMONWEALTH RD
MT PLEASANT SC
29466-8327
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2724
  • Fax: 843-792-8596
Mailing address:
  • Phone: 843-654-9280
  • Fax: 843-792-8596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number9527
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: