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General NPI Number Information
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NPI Number | 1124198361
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Entity Type | Organization
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Legal Business Name | DERMATOLOGY AND LASER CENTER OF CHARLESTON PA
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 04/24/2015
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Provider Practice Location Address
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Address Line | 2180 HENRY TECKLENBURG DR
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City | CHARLESTON
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State | SC
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Zip | 29414-5798
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Country | US
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Telephone | 843-556-8886
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Fax | 843-556-8850
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Provider Business Mailing Address
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Address Line | 2180 HENRY TECKLENBURG DRIVE
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City | CHARLESTON
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State | SC
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Zip | 29414-5741
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Country | US
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Telephone | 843-556-8886
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Fax | 843-556-8850
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. TODD E SCHLESINGER
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Credential | M.D.
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Telephone | 843-556-8886
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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