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General NPI Number Information
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NPI Number | 1972778652
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Entity Type | Individual
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Provider Name | JENNINGS ELLIOTT NESTOR MD
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Gender | Male
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 12/29/2025
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Provider Practice Location Address
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Address Line | 9330 MEDICAL PLAZA DR
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City | CHARLESTON
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State | SC
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Zip | 29406-9104
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Country | US
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Telephone | 304-685-7074
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Fax | 843-847-4843
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Provider Business Mailing Address
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Address Line | 4002 COLONEL VANDERHORST CIR
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City | MOUNT PLEASANT
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State | SC
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Zip | 29466-8043
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Country | US
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Telephone | 304-685-7074
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | TL33704
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 33704
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 33704
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | 201302335
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License Number State | NC
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