DR. TRACY LEIGH CORDRAY (NPI# 1346432614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1346432614 |
Entity Type | Individual |
Full Name | DR. TRACY LEIGH CORDRAY |
Credential | M.D. |
Practice Address |
44 Folly Road Blvd Ste C Charleston SC 29407-7559 |
Practice Telephone | 8437182334 |
Practice Fax Number | 8432772067 |
Mailing Telephone | 8437182334 |
Mailing Fax Number | 8432772067 |
Enumeration Date | 2007-08-10 |
Last Update Date | 2017-12-06 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 208200000X | Plastic Surgery | A79618 | CA | Allopathic & Osteopathic Physicians |
Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
22185 | SC | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
SC | TAX ID | 813653106 | 01 |
SC | MEDICARE PTAN | SC5037G677 | 01 |
SC | INDIVIDUAL NPI | 1346432614 | 01 |
SC | 30236309 | 05 |
Street Address |
44 FOLLY ROAD BLVD STE C |
City | CHARLESTON |
State | SC |
Zip Code | 29407-7559 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225577265 | Cordray Plastic Surgery LLC | Plastic Surgery | 44 Folly Road Blvd Ste C, Charleston, SC 29407-7559 | 2017-02-22 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1437763661 | Charleston Jaw Surgery | Oral & Maxillofacial Surgery | 846 St. Andrews Blvd., Charleston, SC 29407 | 2020-09-04 |
1780225128 | New Endeavors Counseling | Social Worker | 1 Carriage Lane Building E Suite 202, Charleston, SC 29407 | 2019-10-07 |
1770063158 | Katelyn Campbell | Psychologist | 1 Carriage Ln Ste 102, Charleston, SC 29407 | 2018-08-15 |
1164929956 | Anisha Gulati Md LLC | Psychiatry & Neurology | 925 Wappoo Rd., Suite F, Charleston, SC 29407 | 2018-04-09 |
1316459753 | David W Richardson | Dentist | 765 St. Andrews Blvd., Charleston, SC 29407 | 2017-10-25 |
1457874174 | Meca Mentality LLC | Chiropractor | 1106 St Andrews Blvd Suite A, Charleston, SC 29407 | 2017-07-25 |
1639609373 | Carolina Behavioral Specialists, LLC | Behavioral Analyst | 1529 Sam Rittenberg Blvd, Unit 1-b, Charleston, SC 29407 | 2017-06-15 |
1467991901 | Bernice Ladson | Registered Nurse | 75o Magnolia Road, Charleston, SC 29407 | 2017-02-16 |
1376991257 | Virginia Leigh Thomason | Counselor | 29 Leinbach Dr, Suite D2, Charleston, SC 29407 | 2016-06-01 |
1609221001 | Elinor Lee Smith | Counselor | 571 Savannah Hwy, Charleston, SC 29407 | 2016-05-04 |
Find all providers in zip 29407 |
Taxonomy Code | 2086S0122X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Surgery |
Specialization | Plastic and Reconstructive Surgery |
A surgeon who specializes in plastic and reconstructive surgery. |
Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1346365418 | William Aaron Ross | Surgery | 210 Brooks St, Suite 200, Charleston, WV 25301-1855 | 2007-03-20 |
1780797449 | Marcelo L. Hochman | Surgery | 2097 Henry Techlenburg Dr, Suite 212 West, Charleston, SC 29416-5739 | 2006-08-16 |
1811980113 | Abdalla Zackaria Bandak | Surgery | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2005-08-23 |
1891223012 | Sami Paul Tarabishy | Surgery | 169 Ashley Ave Rm 202, Charleston, SC 29425-8905 | 2017-06-01 |
1336328467 | John David Hayes | Surgery | 210 Brooks St, Suite 200, Charleston, WV 25301-1855 | 2007-10-25 |
1457564213 | Bandak Plastic Surgery Pllc | Surgery | 4920 Maccorkle Ave Se, Charleston, WV 25304-2052 | 2007-05-08 |
1871669390 | The Facial Surgery Center | Surgery | 2097 Henry Tecklenburg Dr, Suite 211 West, Charleston, SC 29414-5740 | 2006-11-27 |
1215042155 | Seung-jun O | Surgery | 2097 Henry Tecklenburg Dr, Suite 211 West, Charleston, SC 29414-5740 | 2006-08-20 |
1760405336 | John Robinson | Surgery | 171 Ashley Ave, Charleston, SC 29425-0001 | 2006-07-25 |
1184655862 | Tracy Harvey | Surgery | 2295 Henry Tecklenburg Dr, Charleston, SC 29414-7801 | 2006-07-05 |
Find all providers in CHARLESTON |
City | CHARLESTON |
Zip Code | 29407 |
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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.