Healthcare Provider Details

I. General information

NPI: 1053586776
Provider Name (Legal Business Name): DANIEL ANTHONY WARTINBEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2008
Last Update Date: 07/31/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9100 MEDCOM ST
NORTH CHARLESTON SC
29406-9167
US

IV. Provider business mailing address

9100 MEDCOM ST
NORTH CHARLESTON SC
29406-9167
US

V. Phone/Fax

Practice location:
  • Phone: 843-572-2663
  • Fax:
Mailing address:
  • Phone: 843-572-2663
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number35433
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: