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General NPI Number Information
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NPI Number | 1457414161
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Entity Type | Individual
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Provider Name | ELLIOT SETH STOLERMAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 09/13/2024
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Provider Practice Location Address
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Address Line | 3520 W MONTAGUE AVE STE 104
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City | NORTH CHARLESTON
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State | SC
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Zip | 29418-6083
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Country | US
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Telephone | 843-746-1001
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Fax | 843-735-5097
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Provider Business Mailing Address
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Address Line | 101 GREGOR MENDEL CIR
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City | GREENWOOD
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State | SC
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Zip | 29646-2316
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Country | US
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Telephone | 864-941-8100
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Fax | 864-941-8114
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 56369
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | 214201
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License Number State | MA
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Taxonomy #3
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Taxonomy Code | 207SG0201X
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Taxonomy Name | Clinical Genetics (M.D.) Physician
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License Number | 36225
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License Number State | SC
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