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NPI Code Detail

MEDICARE: JAMIE E MONZINGO AUD

MEDICARE: JAMIE E MONZINGO AUD
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
1231H00000XAudiologist4084SC

General Provider Information

NPI Number : 1982040572
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE E MONZINGO AUD
Provider Business Mailing Address
First Line : 2295 HENRY TECKLENBURG DR
Second Line :
City : CHARLESTON
State : SC
Zip : 29414-7801
Country : US
Telephone Number : 843-766-7103
Fax Number : 803-457-8129
Provider Business Practice Location Address
First Line : 200 ARBOR LAKE DR STE 120
Second Line :
City : COLUMBIA
State : SC
Zip : 29223-4516
Country : US
Telephone Number : 803-457-8120
Fax Number : 803-457-8129
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2013
Last Update Date : 06/16/2022

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Directions to “ JAMIE E MONZINGO AUD” Practice Location

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