MEDICARE: DR. CHRISTOPHER PRESTEL 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
1	208000000X	Pediatrics Physician	LL34998	SC
2	2080P0208X	Pediatric Infectious Diseases Physician	14270697-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LL34998	OTHER	SC	SOUTH CAROLINA LIMITED LICENSE

General Provider Information

NPI Number	:	1689938979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER PRESTEL M.D.

Provider Business Mailing Address
First Line	:	1755 CENTRAL PARK RD
Second Line	:	#3709
City	:	CHARLESTON
State	:	SC
Zip	:	29412-2824
Country	:	US
Telephone Number	:	734-560-9398
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 ASHLEY AVE # MSC561
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-8905
Country	:	US
Telephone Number	:	843-792-8972
Fax Number	:

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

Provider Enumeration Date	:	07/02/2012
Last Update Date	:	06/09/2026

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