Healthcare Provider Details

I. General information

NPI: 1962405316
Provider Name (Legal Business Name): JAMES C CHARLES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 LAKESHORE PKWY
ROCK HILL SC
29730-4205
US

IV. Provider business mailing address

PO BOX 36456
ROCK HILL SC
29732-0507
US

V. Phone/Fax

Practice location:
  • Phone: 803-909-6363
  • Fax: 877-658-8669
Mailing address:
  • Phone: 803-329-0658
  • Fax: 803-325-2984

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number22318
License Number StateSC
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number22318
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: