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CHARLESTON CANCER CENTER PA NPI 1528369667


NPI Information

NPI: 1528369667
Provider Name: CHARLESTON CANCER CENTER, PA
Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

CLIA Number: 42D2194999

Address:
730 STONY LANDING RD
SUITE 200
MONCKS CORNER, SC
ZIP 29461
Phone: (843) 572-9211
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CHARLESTON CANCER CENTER, PA is a hematology and oncology internal medicine in Moncks Corner, 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 1528369667. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

730 STONY LANDING RD
SUITE 200
MONCKS CORNER, SC
ZIP 29461-904
Phone: (843) 572-9211
Fax: (843) 572-9120

The provider's authorized official is Maureen A Melody .
The authorized official title is Finance & Benefits Manager and has the following contact phone number (843) 576-1354.

The CLIA number assigned to this NPI record is 42D2194999 - other - sport med test providers with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/5/2010 and was last updated on 11/5/2010.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207RH0003XInternal MedicineHematology & OncologyYes

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
16292MEDICARE PINSOUTH CAROLINA
2GP2200MEDICAIDSOUTH CAROLINA

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: 5/5/2024

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