Healthcare Provider Details

I. General information

NPI: 1740429398
Provider Name (Legal Business Name): CHARLESTON HEMATOLOGY ONCOLOGY ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2009
Last Update Date: 02/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST SUITE 280
CHARLESTON SC
29403-5736
US

IV. Provider business mailing address

125 DOUGHTY ST SUITE 280
CHARLESTON SC
29403-5736
US

V. Phone/Fax

Practice location:
  • Phone: 843-577-6957
  • Fax: 843-723-3324
Mailing address:
  • Phone: 843-577-6957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberTL1399
License Number StateSC

VIII. Authorized Official

Name: GEORGE FREDERICK GEILS SR.
Title or Position: PRESIDENT
Credential: MD
Phone: 843-577-6957