Healthcare Provider Details

I. General information

NPI: 1437894060
Provider Name (Legal Business Name): DANIELLE RANGEL PARADELA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2022
Last Update Date: 04/28/2022
Certification Date: 04/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVE MSC 333 ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425
US

IV. Provider business mailing address

169 ASHLEY AVE MSC 333 ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-0435
  • Fax:
Mailing address:
  • Phone: 843-792-0435
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL87597
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberLL87597
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: