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General NPI Number Information
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NPI Number | 1851732507
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL SERVICES
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Dates
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Enumeration Date | 07/10/2013
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 3125 ASHLEY PHOSPHATE RD SUITE 114A
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City | NORTH CHARLESTON
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State | SC
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Zip | 29418-8417
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Country | US
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Telephone | 843-360-8005
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Fax |
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Provider Business Mailing Address
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Address Line | 3125 ASHLEY PHOSPHATE RD SUITE 114A
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City | NORTH CHARLESTON
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State | SC
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Zip | 29418-8417
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Country | US
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Telephone | 843-360-8005
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACQUELINE JAVIER
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Credential |
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Telephone | 843-364-8005
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11629
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License Number State | SC
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