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General NPI Number Information
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NPI Number | 1972029692
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Entity Type | Organization
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Legal Business Name | XENON ANESTHESIA OF SOUTH CAROLINA LLC
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Dates
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Enumeration Date | 08/15/2017
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 6650 RIVERS AVE
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City | NORTH CHARLESTON
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State | SC
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Zip | 29406-4809
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Country | US
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Telephone | 323-417-0335
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Fax | 323-978-6136
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Provider Business Mailing Address
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Address Line | 111 TOWN SQUARE PL STE 420
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City | JERSEY CITY
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State | NJ
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Zip | 07310-1724
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Country | US
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Telephone | 888-589-8550
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Fax | 323-978-6136
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAROON W CHAUDHRY
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Credential | MD
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Telephone | 323-417-0335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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