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General NPI Number Information
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NPI Number | 1922111913
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Entity Type | Organization
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Legal Business Name | SOUTHEAST CARDIOLOGY
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 1812 WALLACE SCHOOL RD STE 300
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City | CHARLESTON
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State | SC
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Zip | 29407-4516
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Country | US
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Telephone | 843-766-2011
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Fax | 843-766-2004
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Provider Business Mailing Address
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Address Line | PO BOX 22553
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City | CHARLESTON
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State | SC
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Zip | 29413-2553
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Country | US
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Telephone | 843-766-2011
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Fax | 843-766-2004
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Authorized Official
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Title or Position | PHYSICIAN
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Name | SARBABI MASINDET
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Credential | M.D.
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Telephone | 843-766-2011
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 17874
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License Number State | SC
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