Healthcare Provider Details

I. General information

NPI: 1114012945
Provider Name (Legal Business Name): NATIONAL ALLERGY ASTHMA & URTICARIA CENTERS OF CHARLESTON PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 07/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7555 NORTHSIDE DR
CHARLESTON SC
29420-4211
US

IV. Provider business mailing address

1470 TOBIAS GADSON BLVD SUITE 204
CHARLESTON SC
29407-4707
US

V. Phone/Fax

Practice location:
  • Phone: 843-573-9379
  • Fax: 843-797-8372
Mailing address:
  • Phone: 843-573-9379
  • Fax: 843-573-9970

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. AMBER MURPHY
Title or Position: PRACTICE MANAGER
Credential:
Phone: 843-820-1302