Healthcare Provider Details

I. General information

NPI: 1396108064
Provider Name (Legal Business Name): OLIVER KAYDEN JAWITZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2016
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MUSC DEPARTMENT OF SURGERY 30 COURTENAY DRIVE MSC 295
CHARLESTON SC
29425-0001
US

IV. Provider business mailing address

MUSC DEPARTMENT OF SURGERY 30 COURTENAY DRIVE MSC 295
CHARLESTON SC
29425-0001
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1414
  • Fax:
Mailing address:
  • Phone: 843-792-1414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number96825
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: