Healthcare Provider Details

I. General information

NPI: 1528033263
Provider Name (Legal Business Name): ALLERGY & ASTHMA CONSULTANTS, LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 03/04/2020
Certification Date: 03/04/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

180 WINGO WAY STE 102
MOUNT PLEASANT SC
29464-1810
US

IV. Provider business mailing address

180 WINGO WAY SUITE 102
MT PLEASANT SC
29464-3235
US

V. Phone/Fax

Practice location:
  • Phone: 843-881-2030
  • Fax: 843-881-6249
Mailing address:
  • Phone: 843-881-2030
  • Fax: 843-881-6249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: BRUCE DEVON BALL
Title or Position: MD/ MANAGING PARTNER
Credential: MD
Phone: 843-881-2030