Healthcare Provider Details

I. General information

NPI: 1043206410
Provider Name (Legal Business Name): DONALD P HURLEY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 ASHLEY CROSSING DR STE 150
CHARLESTON SC
29414-5702
US

IV. Provider business mailing address

2834 AQUADUCT ST
CHARLESTON SC
29414-7410
US

V. Phone/Fax

Practice location:
  • Phone: 843-766-1936
  • Fax: 843-766-1206
Mailing address:
  • Phone: 843-766-1936
  • Fax: 843-766-1206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberSC0310
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: