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General NPI Number Information
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NPI Number | 1093764789
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Entity Type | Organization
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Legal Business Name | CAROLINA AESTHETIC PLASTIC SURGERY INSTITUTE PA
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Dates
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Enumeration Date | 05/09/2006
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Last Update Date | 07/16/2013
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Provider Practice Location Address
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Address Line | 180 WINGO WAY SUITE 205
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City | MT PLEASANT
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State | SC
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Zip | 29464-1810
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Country | US
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Telephone | 843-884-1400
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Fax | 843-884-7448
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Provider Business Mailing Address
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Address Line | 180 WINGO WAY SUITE 205
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City | MT PLEASANT
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State | SC
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Zip | 29464-1810
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Country | US
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Telephone | 843-884-1400
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Fax | 843-884-7448
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Authorized Official
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Title or Position | OFFICE MANAGER DIRECTOR
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Name | KENDRA CHRISTMAS
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Credential |
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Telephone | 843-884-1400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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