Healthcare Provider Details

I. General information

NPI: 1811251366
Provider Name (Legal Business Name): BERNARDO FRANSSEN CANOVAS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST STE 660
CHARLESTON SC
29403-5731
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-577-7550
  • Fax: 843-853-5588
Mailing address:
  • Phone: 888-472-0043
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number51495
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: