Healthcare Provider Details
I. General information
NPI: 1821024431
Provider Name (Legal Business Name): ELMS DIGESTIVE DISEASE SPECIALISTS,PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/24/2006
Last Update Date: 01/14/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2671 ELMS PLANTATION BLVD
NORTH CHARLESTON SC
29406-9165
US
IV. Provider business mailing address
2671 ELMS PLANTATION BLVD
NORTH CHARLESTON SC
29406-9165
US
V. Phone/Fax
- Phone: 843-797-6800
- Fax: 843-797-6825
- Phone: 843-797-6800
- Fax: 843-797-6825
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RG0100X |
| Taxonomy | Gastroenterology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TODD
L
SNYDER
Title or Position: PRESIDENT/CEO
Credential: MD
Phone: 843-797-6800