Healthcare Provider Details

I. General information

NPI: 1245443258
Provider Name (Legal Business Name): ARON D ROSENTHAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1241 WOODLAND AVE
MOUNT PLEASANT SC
29464-3288
US

IV. Provider business mailing address

1241 WOODLAND AVE
MOUNT PLEASANT SC
29464-3288
US

V. Phone/Fax

Practice location:
  • Phone: 843-824-0606
  • Fax: 843-824-0909
Mailing address:
  • Phone: 843-824-0606
  • Fax: 843-824-0909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA94087
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: