MEDICARE: CHARLESTON PHYSICIANS FOR WOMEN PLLC

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	207V00000X	Obstetrics & Gynecology Physician

General Provider Information

NPI Number	:	1669568952
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHARLESTON PHYSICIANS FOR WOMEN PLLC

Provider Business Mailing Address
First Line	:	4480 LEEDS PL W
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8402
Country	:	US
Telephone Number	:	843-740-6700
Fax Number	:	843-745-9428

Provider Business Practice Location Address
First Line	:	4480 LEEDS PL W
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29405-8402
Country	:	US
Telephone Number	:	843-740-6700
Fax Number	:	843-745-9428

Authorized Official
Title or Position	:	MANAGING CONSULTANT
Name	:	MR. WILLIAM D KING
Credential	:	CPA
Telephone Number	:	843-740-6700

Provider Enumeration Date	:	10/05/2006
Last Update Date	:	08/22/2020

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