Healthcare Provider Details

I. General information

NPI: 1871032086
Provider Name (Legal Business Name): PPCP SPECIALTY PHYSICIANS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2017
Last Update Date: 06/08/2021
Certification Date: 06/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9313 MEDICAL PLAZA DR STE 310
CHARLESTON SC
29406-9155
US

IV. Provider business mailing address

PO BOX 530062
ATLANTA GA
30353-0062
US

V. Phone/Fax

Practice location:
  • Phone: 843-569-1856
  • Fax: 843-569-1879
Mailing address:
  • Phone: 843-695-6071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number20248
License Number StateSC

VIII. Authorized Official

Name: DR. THOMAS BRANTLEY ARNAU
Title or Position: PRESIDENT
Credential: MD
Phone: 843-572-7727