Provider Type Icon

CHARLESTON CANCER CENTER PA NPI 1043220627


NPI Information

NPI: 1043220627
Provider Name: CHARLESTON CANCER CENTER PA

Former Legal Business Name: TRIDENT PALMETTO HEMATOLOGY ONCOLOGY

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
2910 TRICOM ST
NORTH CHARLESTON, SC
ZIP 29406
Phone: (843) 572-9211
Get Directions

CHARLESTON CANCER CENTER PA is a hematology and oncology internal medicine in North Charleston, SC. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. CHARLESTON CANCER CENTER PA NPI is 1043220627. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Trident Palmetto Hematology Oncology.

The provider's business location address is:

2910 TRICOM ST
NORTH CHARLESTON, SC
ZIP 29406-350
Phone: (843) 572-9211
Fax: (843) 572-0457

The provider's authorized official is Douglas L. Michaelsen .
The authorized official title is Managing Partner and has the following contact phone number (843) 572-9211.

The enumeration date for this NPI number is 8/8/2006 and was last updated on 2/15/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyNo
2207RH0003XInternal MedicineHematology & Oncology18607SOUTH CAROLINANo
3207RH0003XInternal MedicineHematology & Oncology19684SOUTH CAROLINANo
4207RH0003XInternal MedicineHematology & Oncology32155SOUTH CAROLINANo
5207RH0003XInternal MedicineHematology & Oncology30018SOUTH CAROLINANo
6363A00000XPhysician AssistantPA2273SOUTH CAROLINANo
7207RH0003XInternal MedicineHematology & Oncology11628SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C612826292OTHERMEDICARE GROUP NUMBER
21278940001MEDICARE NSC

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.