Healthcare Provider Details

I. General information

NPI: 1376527580
Provider Name (Legal Business Name): SAMUEL KEITH PARISH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2005
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5133 RIVERS AVE
NORTH CHARLESTON SC
29406-6338
US

IV. Provider business mailing address

PO BOX 632516
CINCINNATI OH
45263-2516
US

V. Phone/Fax

Practice location:
  • Phone: 843-789-1786
  • Fax: 843-958-1263
Mailing address:
  • Phone: 888-472-0043
  • Fax: 513-653-4122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number89652
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: