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General NPI Number Information
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NPI Number | 1558300525
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Entity Type | Organization
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Legal Business Name | CHARLESTON PATHOLOGY, P.A.
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Dates
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Enumeration Date | 06/05/2006
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 125 DOUGHTY STREET STE 480
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City | CHARLESTON
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State | SC
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Zip | 29403
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Country | US
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Telephone | 843-769-6345
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Fax | 843-769-7614
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Provider Business Mailing Address
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Address Line | 125 DOUGHTY STREET STE 480
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City | CHARLESTON
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State | SC
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Zip | 29403
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Country | US
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Telephone | 843-769-6345
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Fax | 843-769-7614
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | MRS. SUSAN M BRANAND
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Credential |
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Telephone | 843-442-8365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZC0500X
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Taxonomy Name | Cytopathology Physician
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License Number | 8966
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 8966
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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