CHARLESTON CANCER CENTER (NPI# 1073776464) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073776464 |
| Entity Type | Organization |
| Organization Name | CHARLESTON CANCER CENTER |
| Practice Address |
180 Wingo Way Suite 205 Mt Pleasant SC 29464 |
| Mailing Address |
2910 Tricom Street Charleston SC 29406 |
| Practice Telephone | 8435729211 |
| Mailing Telephone | 8435729211 |
| Mailing Fax Number | 8435720457 |
| Enumeration Date | 2008-07-07 |
| Last Update Date | 2008-07-07 |
| Authorized Official Name | CHARLES D GRAHAM (PRESIDENT) |
| Authorized Official Telephone | 8435720457 |
| Authorized Official Credential | MD |
| Is Organization Subpart | Y |
| Parent Organization Name | CHARLESTON CANCER CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
SC08607 | SC | Allopathic & Osteopathic Physicians |
| N | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
SC19684 | SC | Allopathic & Osteopathic Physicians |
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
SC11628 | SC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477882843 | Charleston Cancer Center | Internal Medicine | 416 Robertson Blvd, Suite B, Walterboro, SC 29488 | 2009-12-15 |
| Street Address |
180 WINGO WAY SUITE 205 |
| City | MT PLEASANT |
| State | SC |
| Zip Code | 29464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003815259 | Stanley C Hall | Urology | 180 Wingo Way, Suite 304, Mt Pleasant, SC 29464-1810 | 2005-07-19 |
| 1114371846 | Roper Saint Francis Physicians Network | Durable Medical Equipment & Medical Supplies | 180 Wingo Way, Suite 308, Mt Pleasant, SC 29464-1810 | 2016-04-19 |
| 1285098939 | Lillian Brandt | Specialist | 180 Wingo Way, Suite 301, Mt Pleasant, SC 29464-1810 | 2016-04-08 |
| 1235598525 | Roper Saint Francis Physicians Network | Internal Medicine | 180 Wingo Way, Suite 110, Mt Pleasant, SC 29464-1810 | 2016-02-16 |
| 1598142101 | Roper Saint Francis Physicians Network | Obstetrics & Gynecology | 180 Wingo Way, Suite 308, Mt Pleasant, SC 29464-1810 | 2015-05-04 |
| 1497184667 | Charleston Ent Associates LLC | Pharmacy | 180 Wingo Way, Suite 103, Mt Pleasant, SC 29464-1810 | 2013-11-07 |
| 1629327713 | Jessica Michelle Chepa | Nurse Practitioner | 180 Wingo Way, Suite 304, Mt Pleasant, SC 29464-1810 | 2012-09-05 |
| 1093091761 | Jesse William Price IIi | Physician Assistant | 180 Wingo Way, Suite 306, Mt Pleasant, SC 29464-1812 | 2011-10-26 |
| 1659663441 | Andrew Clarke Flandry | Family Medicine | 180 Wingo Way, Suite 207, Mt Pleasant, SC 29464-1810 | 2011-05-11 |
| 1053613786 | Brian R Obenza | Physician Assistant | 180 Wingo Way, Suite 204, Mt Pleasant, SC 29464-1810 | 2010-12-01 |
| Find all providers in the same location | ||||
| 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 | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| 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. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477727139 | Ryan Adam Kalinsky | Internal Medicine | 900 Bowman Rd, Suite 103, Mt Pleasant, SC 29464-3203 | 2008-04-14 |
| 1912178682 | Cancer Control Center of Charleston,llc | Internal Medicine | 1405 Ben Sawyer Blvd, Mt Pleasant, SC 29464-5519 | 2008-03-20 |
| 1164566550 | Yanis Bellil | Internal Medicine | 900 Bowman Rd, Suite 103, Mt Pleasant, SC 29464-3203 | 2007-02-18 |
| 1528081783 | Pascale A. Salem | Internal Medicine | 900 Bowman Rd, Suite 103, Mt Pleasant, SC 29464-3203 | 2006-07-26 |
| 1275554594 | M. Daud Nawabi | Internal Medicine | 900 Bowman Rd, Suite 103, Mt Pleasant, SC 29464-3203 | 2006-07-21 |
| 1851322747 | Somdev Roy | Internal Medicine | 1221 South Dr, Mt Pleasant, MI 48858-3258 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508361809 | Santee Oncology, LLC | Internal Medicine | 1105 N Lafayette Dr Ste A, Sumter, SC 29150-2984 | 2018-03-28 |
| 1689080129 | Gregory Michael Haidemenos | Internal Medicine | 169 Ashley Ave # Msc322, Charleston, SC 29425-8908 | 2014-07-04 |
| 1558507848 | Shelly Christiansen Shand | Internal Medicine | 2085 Henry Tecklenburg Dr Fl 2, Charleston, SC 29414 | 2008-12-17 |
| 1598922650 | Xuezhong Yang | Internal Medicine | 317 Saint Francis Dr Ste 340, Greenville, SC 29601-3914 | 2008-05-16 |
| 1891817656 | Carolina Cancer Specialists | Internal Medicine | 225 S Herlong Ave, Suite 201, Rock Hill, SC 29732-2730 | 2007-04-04 |
| 1730200031 | Niyati Anand Nathwani | Internal Medicine | 902 W Meeting St, Lancaster, SC 29720-6219 | 2007-04-03 |
| 1770601734 | Ziad Georges Skaff | Internal Medicine | 8950 University Blvd Ste 100, North Charleston, SC 29406-9115 | 2007-03-27 |
| 1407947757 | Asutosh S Gor | Internal Medicine | 1583 Healthcare Drive, Rock Hill, SC 29732 | 2006-09-28 |
| 1821192949 | Sitki M Ergul | Internal Medicine | 111 Miracle Drive, Aiken, SC 29801 | 2006-09-11 |
| 1295742294 | Palmetto Hematology Oncology PC | Internal Medicine | 406 Tiffany Park, Suites A & B, Gaffney, SC 29341-1262 | 2006-08-02 |
| Find all providers with the same taxonomy | ||||
| City | MT 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.