MEDICARE: JOHN GARDNER INMAN 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
1	207Q00000X	Family Medicine Physician	17289	SC

General Provider Information

NPI Number	:	1255495644
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN GARDNER INMAN MD

Provider Business Mailing Address
First Line	:	181 CALHOUN ST
Second Line	:	STUDENT HEALTH SERVICES COLLEGE OF CHARLESTON
City	:	CHARLESTON
State	:	SC
Zip	:	29424-3519
Country	:	US
Telephone Number	:	843-953-5520
Fax Number	:

Provider Business Practice Location Address
First Line	:	880 ISLAND PARK DR UNIT 200
Second Line	:
City	:	DANIEL ISLAND
State	:	SC
Zip	:	29492-2902
Country	:	US
Telephone Number	:	843-856-1771
Fax Number	:	843-856-8788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	11/06/2019

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