Healthcare Provider Details

I. General information

NPI: 1043275357
Provider Name (Legal Business Name): BARBARA PUTNEY HILDRETH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2006
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5133 RIVERS AVE
N CHARLESTON SC
29406-6338
US

IV. Provider business mailing address

PO BOX 751649
CHARLOTTE NC
28275-1649
US

V. Phone/Fax

Practice location:
  • Phone: 843-789-1786
  • Fax:
Mailing address:
  • Phone: 843-789-1620
  • Fax: 843-724-2440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number14053
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: