MEDICAL UNIVERSITY OF SC (NPI# 1194026153) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194026153 |
| Entity Type | Organization |
| Organization Name | MEDICAL UNIVERSITY OF SC |
| Other Organization Name | DIVISION OF ORAL PATHOLOGY |
| Practice Address |
173 Ashley Ave Charleston SC 29425-8908 |
| Mailing Address |
Msc 507 173 Ashley Avenue Charleston SC 29425-0001 |
| Practice Telephone | 8437924495 |
| Practice Fax Number | 8437923697 |
| Mailing Telephone | 8437924495 |
| Mailing Fax Number | 8437923697 |
| Enumeration Date | 2010-11-08 |
| Last Update Date | 2020-03-04 |
| Authorized Official Name | DR. BRAD W. NEVILLE (DIRECTOR OF DIVISION OF ORAL PATHOL) |
| Authorized Official Telephone | 8437924496 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0106X |
Dentist Specialization: Oral and Maxillofacial Pathology |
Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | 2375 | 05 | |
| SC | ZX0019 | 05 |
| Other Name | Type Code |
|---|---|
| Division of Oral Pathology | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295840148 | Medical University of Sc | Pharmacy | 650 Ellis Oak Dr Rm 119, Charleston, SC 29412-3089 | 2006-08-20 |
| 1013321744 | Medical University of Sc | General Acute Care Hospital | 67 President St, Charleston, SC 29425 | 2014-06-20 |
| Street Address |
173 ASHLEY AVE |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-8908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053303966 | Mullen O Coover | Dentist | 173 Ashley Ave, Bsb-335, Charleston, SC 29425-8908 | 2005-08-17 |
| 1093331472 | Austin Anthony Hughes | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-22 |
| 1205489739 | Frances Gouldin | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2019-07-23 |
| 1093105579 | Timothy Rohde | Dentist | 173 Ashley Ave, Bsb 546, Msc 507, Charleston, SC 29425-8908 | 2015-02-04 |
| 1639593254 | Medical University of South Carolina | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2014-02-18 |
| 1780902734 | Jompobe Vuthiganon | Dentist | 173 Ashley Ave, Bsb Rm 546, Charleston, SC 29425-8908 | 2010-05-13 |
| 1558595074 | Mark Lane Mcentire | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2009-05-12 |
| 1902069271 | Michael Kinon Lecholop | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2008-07-08 |
| 1174708010 | Frederick Thomas Moore | Dentist | 173 Ashley Ave, Bsb 249, Charleston, SC 29425-8908 | 2008-01-09 |
| 1952517161 | Musc College of Dental Medicine | Clinic/Center | 173 Ashley Ave, Bsb 246, Charleston, SC 29425-0001 | 2007-05-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 1223P0106X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Pathology |
| The specialty of dentistry and discipline of pathology that deals with the nature, identification, and management of diseases affecting the oral and maxillofacial regions. It is a science that investigates the causes, processes, and effects of these diseases. The practice of oral and maxillofacial pathology includes research and diagnosis of diseases using clinical, radiographic, microscopic, biochemical, or other examinations. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912969502 | Theresa Sullivan Gonzales | Dentist | 173 Ashley Avenue Msc 507, Charleston, SC 29401 | 2006-04-06 |
| 1639593254 | Medical University of South Carolina | Dentist | 173 Ashley Ave, Charleston, SC 29425-8908 | 2014-02-18 |
| 1396904405 | Christel Maria Haberland | Dentist | 171 Ashley Ave, Charleston, SC 29425-4804 | 2008-06-03 |
| 1275614828 | Brad Wesley Neville | Dentist | 173 Ashley Ave, Room 544 Bsb, Division of Oral Pathology, Musc, Charleston, SC 29425-5070 | 2006-10-18 |
| 1255304606 | Angela C Chi | Dentist | 173 Ashley Ave, Musc College of Dental Medicine, Charleston, SC 29425-0001 | 2006-02-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407067473 | Northeast Oral & Maxillofacial | Dentist | 1118 Greenlawn Dr, Columbia, SC 29209-2606 | 2007-05-24 |
| 1174656540 | River Falls Oral Surgery | Dentist | 700 Squires Pt, Duncan, SC 29334-8879 | 2007-03-14 |
| 1871606830 | Jonathan M Lafond | Dentist | 455 Old Trolley Rd, Ste E, Summerville, SC 29485-5669 | 2006-08-16 |
| 1982622585 | Derek T Dunlap | Dentist | 700 Squire's Pointe Drive, Suite A, Duncan, SC 29334 | 2006-07-18 |
| 1831156777 | Larry Wayne Cobb | Dentist | 2c Cleveland Ct, Greenville, SC 29607-2414 | 2006-04-26 |
| 1891774162 | Thomas Herbert Simpson Jr. | Dentist | 372 S Herlong Ave, Rock Hill, SC 29732 | 2006-01-13 |
| 1518177807 | Orangeburg Oral Surgery & Implant Center | Dentist | 1175 Cook Rd, Ste 135, Orangeburg, SC 29118-8201 | 2007-05-23 |
| 1619008547 | Greenville Oral Surgery, P.a. | Dentist | 3929 S Highway 14, Greenville, SC 29615-6138 | 2007-03-09 |
| 1700916822 | Northeast Oral & Maxillofacial Surgery Center | Dentist | 9310 Two Notch Rd, Columbia, SC 29223-6416 | 2007-03-07 |
| 1801976162 | Kenneth M. Burtner | Dentist | 105 Ben Casey Dr, Suite 115, Fort Mill, SC 29708-8561 | 2006-10-17 |
| Find all providers with the same taxonomy | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
Please comment or provide details below to improve the information on MEDICAL UNIVERSITY OF SC.
| 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.