Healthcare Provider Details

I. General information

NPI: 1417047333
Provider Name (Legal Business Name): CHRISTOPER D. HUIET P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2006
Last Update Date: 02/03/2021
Certification Date: 02/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1005 E CHEVES ST
FLORENCE SC
29506-2707
US

IV. Provider business mailing address

PO BOX 3239
FLORENCE SC
29502-3239
US

V. Phone/Fax

Practice location:
  • Phone: 843-777-7900
  • Fax: 843-777-7102
Mailing address:
  • Phone: 843-777-7097
  • Fax: 843-777-7102

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number646
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number646
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: