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General NPI Number Information
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NPI Number | 1780824755
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Entity Type | Individual
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Provider Name | PUJA SUKHWANI ELIAS M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 07/02/2012
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Provider Practice Location Address
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Address Line | 25 COURTENAY DR ART 7100A MSC 290
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City | CHARLESTON
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State | SC
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Zip | 29425-8911
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Country | US
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Telephone | 843-876-4701
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Fax |
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Provider Business Mailing Address
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Address Line | 25 COURTENAY DR # 7100A MSC 290
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City | CHARLESTON
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State | SC
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Zip | 29425-8911
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Country | US
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Telephone | 843-876-0321
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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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | TL31655
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License Number State | SC
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