Healthcare Provider Details

I. General information

NPI: 1285691170
Provider Name (Legal Business Name): PHILIP ANTON ALBANEZE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2006
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2145 HENRY TECKLENBURG DR STE 100
CHARLESTON SC
29414-5894
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-556-0036
  • Fax: 843-556-3871
Mailing address:
  • Phone: 888-472-0043
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number01052812A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number83831
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD466974
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: