Healthcare Provider Details

I. General information

NPI: 1720996283
Provider Name (Legal Business Name): CHARLESTON RHEUMATOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3423 MAYBANK HWY
JOHNS ISLAND SC
29455-4821
US

IV. Provider business mailing address

3423 MAYBANK HWY
JOHNS ISLAND SC
29455-4821
US

V. Phone/Fax

Practice location:
  • Phone: 843-737-5206
  • Fax:
Mailing address:
  • Phone: 843-737-5206
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NICHOLAS HOLDGATE
Title or Position: OWNER/MEMBER
Credential: MD
Phone: 843-452-5865