Healthcare Provider Details

I. General information

NPI: 1164049011
Provider Name (Legal Business Name): ORLIN O SERGEV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2020
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 CALHOUN ST
CHARLESTON SC
29401-1113
US

IV. Provider business mailing address

316 CALHOUN ST
CHARLESTON SC
29401-1113
US

V. Phone/Fax

Practice location:
  • Phone: 843-402-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number4301513549
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: