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General NPI Number Information
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NPI Number | 1871676684
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Entity Type | Individual
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Provider Name | LESLIE CHARDKOFF SCARLETT M.D.
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 03/07/2022
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Provider Practice Location Address
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Address Line | 2861 TRICOM ST
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City | N CHARLESTON
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State | SC
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Zip | 29406-9172
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Country | US
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Telephone | 843-820-2020
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Fax | 843-735-6211
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Provider Business Mailing Address
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Address Line | 2861 TRICOM ST
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City | N CHARLESTON
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State | SC
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Zip | 29406-9172
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Country | US
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Telephone | 843-820-2020
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Fax | 843-735-6211
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 24449
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License Number State | SC
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