Healthcare Provider Details

I. General information

NPI: 1316175334
Provider Name (Legal Business Name): EMILY A OGDEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2009
Last Update Date: 06/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVE ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425-8905
US

IV. Provider business mailing address

169 ASHLEY AVE ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425-8905
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1086
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberLL31931
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: