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NPI Code Detail

MEDICARE: JOHN FOSTER SORRELL M.D.

MEDICARE: JOHN FOSTER SORRELL M.D.
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
1208D00000XGeneral Practice Physician11406SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1356420442
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN FOSTER SORRELL M.D.
Provider Business Mailing Address
First Line : PO BOX 751649
Second Line :
City : CHARLOTTE
State : NC
Zip : 28275-1649
Country : US
Telephone Number : 888-472-0043
Fax Number :
Provider Business Practice Location Address
First Line : 319 FOLLY RD
Second Line :
City : CHARLESTON
State : SC
Zip : 29412-2518
Country : US
Telephone Number : 843-203-2246
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2006
Last Update Date : 07/30/2024

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