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NPI Code Detail

MEDICARE: MR. TITUS DANIEL CADDELL SR. MD

MEDICARE: MR. TITUS DANIEL CADDELL SR. MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician12475SC

General Provider Information

NPI Number : 1144233735
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. TITUS DANIEL CADDELL SR. MD
Provider Business Mailing Address
First Line : 588 OLD MOUNT HOLLY RD
Second Line :
City : GOOSE CREEK
State : SC
Zip : 29445-2814
Country : US
Telephone Number : 843-376-5595
Fax Number : 843-797-7432
Provider Business Practice Location Address
First Line : 588 OLD MOUNT HOLLY RD
Second Line :
City : GOOSE CREEK
State : SC
Zip : 29445-2814
Country : US
Telephone Number : 843-376-5595
Fax Number : 843-797-7432
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 04/23/2015

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