Healthcare Provider Details
I. General information
NPI: 1720228661
Provider Name (Legal Business Name): NICHOLAS A STRANEY DPM
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/05/2009
Last Update Date: 03/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
701 SAINT ANDREWS BLVD
CHARLESTON SC
29407-7140
US
IV. Provider business mailing address
701 SAINT ANDREWS BLVD
CHARLESTON SC
29407-7140
US
V. Phone/Fax
- Phone: 843-571-3777
- Fax: 843-763-0285
- Phone: 843-571-3777
- Fax: 843-763-0285
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 213ES0131X |
| Taxonomy | Foot Surgery Podiatrist |
| License Number | PD043 |
| License Number State | SC |
VIII. Authorized Official
Name:
NICHOLAS
A
STRANEY
Title or Position: SOLE PROPIETOR
Credential: DPM
Phone: 843-571-3777