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General NPI Number Information
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NPI Number | 1578626552
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Entity Type | Organization
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Legal Business Name | CHARLESTON WOMENS WELLNESS CENTER, LLC
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 04/26/2016
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Provider Practice Location Address
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Address Line | 5319 PARKSHIRE WAY
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City | CHARLESTON
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State | SC
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Zip | 29418-2102
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Country | US
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Telephone | 843-767-2121
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Fax | 843-767-2102
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Provider Business Mailing Address
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Address Line | 5319 PARKSHIRE WAY
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City | CHARLESTON
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State | SC
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Zip | 29418-2102
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Country | US
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Telephone | 843-767-2121
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Fax | 843-767-2102
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. PAULA ORR
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Credential | MD
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Telephone | 843-767-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20332
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License Number State | SC
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