Healthcare Provider Details

I. General information

NPI: 1427345016
Provider Name (Legal Business Name): CORTNEY S DRAPER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CALHOUN STREET
CHARLESTON SC
29401-1113
US

IV. Provider business mailing address

PO BOX 601495
CHARLOTTE NC
28260-1495
US

V. Phone/Fax

Practice location:
  • Phone: 843-724-2010
  • Fax: 843-724-2005
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number4301098558
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number37139
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: