Healthcare Provider Details

I. General information

NPI: 1558105247
Provider Name (Legal Business Name): NITESH GANDHI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2024
Last Update Date: 06/19/2024
Certification Date: 06/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9181 MEDCOM ST
NORTH CHARLESTON SC
29406-9168
US

IV. Provider business mailing address

845 HOUSTON NORTHCUTT BLVD # 1061
MOUNT PLEASANT SC
29464-3446
US

V. Phone/Fax

Practice location:
  • Phone: 843-820-7777
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State

VIII. Authorized Official

Name: NITESH GANDHI
Title or Position: PHYSICIAN/OWNER
Credential: MD
Phone: 478-456-2059