Healthcare Provider Details

I. General information

NPI: 1891934253
Provider Name (Legal Business Name): NORTH AREA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/09/2009
Last Update Date: 02/09/2009
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

205 SAINT JAMES AVE
GOOSE CREEK SC
29445-2997
US

V. Phone/Fax

Practice location:
  • Phone: 843-797-6800
  • Fax: 843-797-6825
Mailing address:
  • Phone: 843-797-6800
  • Fax: 843-797-6825

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: JUDD BRONE ADELMAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 843-797-6800