Healthcare Provider Details

I. General information

NPI: 1295652642
Provider Name (Legal Business Name): BILAL BERKE AYVAZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2026
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 RUTLEDGE AVE FL 6
CHARLESTON SC
29425-8903
US

IV. Provider business mailing address

169 ASHLEY AVE RM 202
CHARLESTON SC
29425-8905
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-3222
  • Fax:
Mailing address:
  • Phone: 843-792-3222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberLL97504
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: