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General NPI Number Information
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NPI Number | 1821268384
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Entity Type | Organization
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Legal Business Name | DAVID D. EGLESTON MD, PA
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Dates
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Enumeration Date | 03/11/2008
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Last Update Date | 05/20/2008
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Provider Practice Location Address
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Address Line | 418 FOLLY RD SUITE A
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City | CHARLESTON
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State | SC
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Zip | 29412-2625
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Country | US
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Telephone | 843-795-5362
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Fax | 843-795-1921
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Provider Business Mailing Address
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Address Line | 418 FOLLY RD SUITE A
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City | CHARLESTON
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State | SC
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Zip | 29412-2625
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Country | US
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Telephone | 843-795-5362
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Fax | 843-795-1921
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAVID D. EGLESTON
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Credential | MD
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Telephone | 843-795-5362
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number |
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License Number State |
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