Healthcare Provider Details

I. General information

NPI: 1679685333
Provider Name (Legal Business Name): MEDICAL UNIVESRSITY OF SOUTH CAROLINA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

171 ASHLEY AVE
CHARLESTON SC
29425-0001
US

IV. Provider business mailing address

171 ASHLEY AVE
CHARLESTON SC
29425-0001
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-2123
  • Fax: 843-792-8801
Mailing address:
  • Phone: 843-792-2123
  • Fax: 843-792-8801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number10206
License Number StateSC

VIII. Authorized Official

Name: DR. LYNDON KEY
Title or Position: CHAIRMAN
Credential: MD
Phone: 843-876-1417