Healthcare Provider Details

I. General information

NPI: 1295715977
Provider Name (Legal Business Name): HUGH D. DURRENCE, MD, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 FOLLY RD SUITE A
CHARLESTON SC
29412-2625
US

IV. Provider business mailing address

418 FOLLY RD SUITE A
CHARLESTON SC
29412-2625
US

V. Phone/Fax

Practice location:
  • Phone: 843-795-5362
  • Fax: 843-795-1921
Mailing address:
  • Phone: 843-795-5362
  • Fax: 843-795-1921

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18668
License Number StateSC

VIII. Authorized Official

Name: DR. HUGH D DURRENCE
Title or Position: COO
Credential: R.PH., MD
Phone: 843-795-5362