Healthcare Provider Details

I. General information

NPI: 1104188002
Provider Name (Legal Business Name): REBECCA ROWSEY DESSO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA TERRY ROWSEY

II. Dates (important events)

Enumeration Date: 06/15/2012
Last Update Date: 10/20/2021
Certification Date: 10/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

167 ASHLEY AVE SUITE 301
CHARLESTON SC
29425-9120
US

IV. Provider business mailing address

169 ASHLEY AVE ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425-8905
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2322
  • Fax:
Mailing address:
  • Phone: 843-792-2322
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberLL34922
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: