Healthcare Provider Details

I. General information

NPI: 1568469435
Provider Name (Legal Business Name): CARL WILLY SCHWENZFEIER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 07/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

497 SAINT ANDREWS BLVD
CHARLESTON SC
29407-7184
US

IV. Provider business mailing address

497 SAINT ANDREWS BLVD
CHARLESTON SC
29407-7184
US

V. Phone/Fax

Practice location:
  • Phone: 843-763-0543
  • Fax:
Mailing address:
  • Phone: 843-763-0543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number08647
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: