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NPI Code Detail

MEDICARE: SOUTH CAROLINA ANESTHESIA ASSOCIATES, LLC

MEDICARE: SOUTH CAROLINA ANESTHESIA ASSOCIATES, LLC
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
1207L00000XAnesthesiology Physician

General Provider Information

NPI Number : 1184928590
Entity Type Code : Organization
Provider Name (Legal Business Name) : SOUTH CAROLINA ANESTHESIA ASSOCIATES, LLC
Provider Business Mailing Address
First Line : 5665 NEW NORTHSIDE DR NW
Second Line : SUITE 320
City : ATLANTA
State : GA
Zip : 30328-5831
Country : US
Telephone Number : 770-874-5400
Fax Number : 770-874-5483
Provider Business Practice Location Address
First Line : 2000 HOSPITAL DR
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-3764
Country : US
Telephone Number : 843-881-0100
Fax Number :
Authorized Official
Title or Position : PRESIDENT
Name : MR. CHRISTOPHER BRIAN DURHAM
Credential :
Telephone Number : 770-874-5400
Provider Enumeration Date : 12/28/2010
Last Update Date : 03/03/2017

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Directions to “SOUTH CAROLINA ANESTHESIA ASSOCIATES, LLC ” Practice Location

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