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General NPI Number Information
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NPI Number | 1235108721
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Entity Type | Organization
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Legal Business Name | CHARLESTON INTERNAL MEDICINE, LLC
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 537 FOLLY RD
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City | CHARLESTON
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State | SC
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Zip | 29412-3007
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Country | US
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Telephone | 843-406-4948
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Fax | 843-406-4940
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Provider Business Mailing Address
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Address Line | 537 FOLLY RD
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City | CHARLESTON
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State | SC
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Zip | 29412-3007
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Country | US
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Telephone | 843-406-4948
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Fax | 843-406-4940
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Authorized Official
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Title or Position | MEMBER
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Name | DR. SHANON WELCH HONNEY
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Credential | M.D.
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Telephone | 843-406-4948
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 22489
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License Number State | SC
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