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SOUTHEAST WOUND SPECIALISTS LLC NPI 1114953742


NPI Information

NPI: 1114953742
Provider Name: SOUTHEAST WOUND SPECIALISTS, LLC
Classification: Emergency Medicine - 207P00000X
Entity Type: Organization
Address:
9302 MEDIAL PLAZA DRIVE
SUITE A
CHARLESTON, SC
ZIP 29406
Phone: (912) 232-9700
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SOUTHEAST WOUND SPECIALISTS, LLC is an emergency medicine in Charleston, SC. The provider is an emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. SOUTHEAST WOUND SPECIALISTS, LLC NPI is 1114953742. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

9302 MEDIAL PLAZA DRIVE
SUITE A
CHARLESTON, SC
ZIP 29406-142
Phone: (912) 232-9700
Fax: (912) 748-0270

The provider's authorized official is Timothy J. Gregory .
The authorized official title is Owner and has the following contact phone number (912) 232-9700.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 7/21/2022.


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
1207PE0005XEmergency MedicineUndersea and Hyperbaric MedicineNo
2207P00000XEmergency MedicineYes

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
1GP4454MEDICAIDSOUTH CAROLINA
2013997MEDICAIDGEORGIA

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: 4/28/2024

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