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General NPI Number Information
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NPI Number | 1538083274
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Entity Type | Individual
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Provider Name | FAHAD ALDAWSARI MD
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Gender | Male
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Dates
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Enumeration Date | 08/06/2026
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Last Update Date | 08/06/2026
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Provider Practice Location Address
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Address Line | 25 COURTENAY DRIVE MSC 226 DIVISION OF VASCULAR & INTERVENTIONAL RADIOLOGY
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City | CHARLESTON
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State | SC
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Zip | 29425
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Country | US
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Telephone | 843-792-9271
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Fax |
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Provider Business Mailing Address
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Address Line | 99 WESTEDGE ST
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City | CHARLESTON
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State | SC
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Zip | 29403-4717
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Country | US
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Telephone | 843-330-7566
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Fax |
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | MDD.LL97572
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License Number State | SC
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