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General NPI Number Information
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NPI Number | 1053833178
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Entity Type | Organization
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Legal Business Name | CHARLESTON ENT ASSOCIATES
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Dates
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Enumeration Date | 07/11/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 23 MAIN ST STE 201
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City | HILTON HEAD
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State | SC
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Zip | 29926-6607
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Country | US
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Telephone | 843-682-3955
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Fax |
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Provider Business Mailing Address
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Address Line | 2295 HENRY TECKLENBURG DR
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City | CHARLESTON
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State | SC
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Zip | 29414-7801
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Country | US
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Telephone | 843-766-7103
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE G BROWN
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Credential | MD
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Telephone | 843-766-7103
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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