Healthcare Provider Details

I. General information

NPI: 1962107367
Provider Name (Legal Business Name): RACHEL DUNCAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/04/2023
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST STE 520
CHARLESTON SC
29403-5784
US

IV. Provider business mailing address

125 DOUGHTY ST STE 520
CHARLESTON SC
29403-5784
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2957
  • Fax:
Mailing address:
  • Phone: 843-792-2957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberLL89857
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: