MEDICARE: DR. JASON DANIEL HUET 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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	TL32685	SC
2	207RP1001X	Pulmonary Disease Physician	57.008655	OH
3	207RP1001X	Pulmonary Disease Physician	32685	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00908549	OTHER	SC	RAILROAD MC ID-RSFPN
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841415155
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JASON DANIEL HUET M.D.

Provider Business Mailing Address
First Line	:	PO BOX 751649
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28275-1649
Country	:	US
Telephone Number	:	843-789-1620
Fax Number	:	843-724-2440

Provider Business Practice Location Address
First Line	:	3510 N HIGHWAY 17 STE 110
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29466-8228
Country	:	US
Telephone Number	:	843-763-3360
Fax Number	:	843-763-3038

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

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	12/16/2020

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Directions to “ DR. JASON DANIEL HUET M.D.” Practice Location

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