CHARLESTON VASCULAR SURGERY, P.C. (NPI# 1043766017) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043766017 |
| Entity Type | Organization |
| Organization Name | CHARLESTON VASCULAR SURGERY, P.C. |
| Practice Address |
1280 Hospital Drive, Suite 302 Charleston Vascular Surgery, P.C. Mount Pleasant SC 29464-1901 |
| Mailing Address |
Po Box 2024 Charleston Vascular Surgery, P.C. Mount Pleasant SC 29465-2024 |
| Practice Telephone | 8438849900 |
| Practice Fax Number | 8439366699 |
| Mailing Telephone | 8438849900 |
| Mailing Fax Number | 8439366699 |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2016-11-21 |
| Authorized Official Name | DR. RICK M. ROBERTS (CO-PRESIDENT) |
| Authorized Official Telephone | 8438849900 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
Allopathic & Osteopathic Physicians |
| Street Address |
1280 HOSPITAL DRIVE, SUITE 302 CHARLESTON VASCULAR SURGERY, P.C. |
| City | MOUNT PLEASANT |
| State | SC |
| Zip Code | 29464-1901 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811548241 | Bradley Paul Anuszkiewicz | Chiropractor | 1501 Johnnie Dodds Blvd, Suite C, Mount Pleasant, SC 29464 | 2019-09-26 |
| 1447808696 | Laura Mariah Crouse | Speech-Language Pathologist | Coastal Therapy Services, 1127 Queensborough Blvd, Mt Pleasant, SC 29464 | 2019-08-30 |
| 1912461807 | Independent Optical | Optometrist | 1710 Shoremead Rd, Suite 420, Mount Pleasant, SC 29464 | 2019-01-25 |
| 1417446204 | Michael Adam Sugarman | Clinical Neuropsychologist | 1459 Stuart Engals Blvd Ste 204a, Mt Pleasant, SC 29464 | 2018-05-07 |
| 1578064192 | Ancillary Specialists LLC | Durable Medical Equipment & Medical Supplies | 636 Long Point Road, Unit G, #19, Mount Pleasant, SC 29464 | 2018-02-28 |
| 1346769015 | Christin Solomon Zerega | Counselor | Lowcountry Psychiatry Group, 913 Bowman Rd, #4, Mount Pleasant, SC 29464 | 2017-09-14 |
| 1336660315 | Charleston Neuropsychology LLC | Psychologist | 1459 Stuart Engals Blvd., Suite 204a, Mount Pleasant, SC 29464 | 2017-06-29 |
| 1790219970 | Adam Hudepohl | Family Medicine | 1400 Ben Sawyer Blvd, Mt Pleasant, SC 29464 | 2017-04-14 |
| 1386181204 | Alicia Taylor | Speech-Language Pathologist | 381 Stonewall Ct Apt 6207, Mount Pleasant, SC 29464 | 2017-01-30 |
| 1285181941 | Tara Lynn Mast | Physical Therapist | 1400 Caliper Oak Circle, Apt 316, Mount Pleasant, SC 29464 | 2016-09-09 |
| Find all providers in zip 29464 | ||||
| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518149350 | Thomas Russell Wieters, M.d., P.a. | Surgery | 3070 Highway 17 N, Suite 202, Mount Pleasant, SC 29466-9300 | 2007-12-04 |
| 1114174125 | Jonathan Kittredge | Surgery | 1280 Hospital Dr Unit 302, Mount Pleasant, SC 29464-1901 | 2008-08-20 |
| 1740379916 | Edward C. Morrison | Surgery | 851 Leonard Fulghum Dr Ste 100, Mount Pleasant, SC 29464-3793 | 2006-10-12 |
| 1255368106 | Thomas R Wieters | Surgery | 3070 N Highway 17, Suite 202, Mount Pleasant, SC 29466-9300 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1104237338 | William Jackson | Surgery | 101 S Ravenel St Ste 230, Florence, SC 29506-2624 | 2014-05-09 |
| 1962765081 | Goatee Vascular LLC | Surgery | 4036 River Oaks Dr, Unit B2, Myrtle Beach, SC 29579-6695 | 2012-06-22 |
| 1801985007 | Thomas C. Appleby | Surgery | 1327 Ashley River Road, Building B, Charleston, SC 29407 | 2006-10-12 |
| 1962519546 | Mary Black Health System LLC | Surgery | 1690 Skylyn Dr Ste 350, Spartanburg, SC 29307-1039 | 2006-08-23 |
| 1164536215 | Sean J Hislop | Surgery | 1327 Ashley River Rd, Charleston, SC 29407-5384 | 2006-08-18 |
| 1881600963 | Louis F Knoepp IIi | Surgery | 100 Health Way, Suite 1240, Anderson, SC 29621-7917 | 2006-07-31 |
| 1659321115 | Robert C. Allen | Surgery | 197 Piedmont Blvd Ste 100, Rock Hill, SC 29732-1824 | 2006-05-12 |
| 1164496527 | The Regional Medical Center of Orangeburg and Calhoun Counties | Surgery | 1175 Cook Rd Ste 320, Orangeburg, SC 29118-8247 | 2006-02-14 |
| 1063499226 | Newberry Surgical Associates Pa | Surgery | 2541 Evans Street, Suite 100, Newberry, SC 29108 | 2005-12-29 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT PLEASANT |
| Zip Code | 29464 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.