NICHOLAS MATTHEW CUNDIFF (NPI# 1720518384) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720518384 |
| Entity Type | Individual |
| Full Name | NICHOLAS MATTHEW CUNDIFF |
| Credential | DO |
| Practice Address |
135 Rutledge Ave Dept Of Charleston SC 29425-8903 |
| Mailing Address |
169 Ashley Ave Rm 202 Charleston SC 29425-8905 |
| Practice Telephone | 8438761698 |
| Practice Fax Number | 8438761435 |
| Mailing Telephone | 8437922575 |
| Mailing Fax Number | 8437929295 |
| Enumeration Date | 2017-06-15 |
| Last Update Date | 2017-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | LL41060 | SC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| SC | SOUTH CAROLINA BOARD OF MEDICAL EXAMINERS | LL41060 | 01 |
| Street Address |
135 RUTLEDGE AVE DEPT OF |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-8903 |
| 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 | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| 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 Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023632809 | Caitlin Marie Stoll | Pediatrics | 2244 Ashley Crossing Dr Unit 536, Charleston, SC 29414-6168 | 2020-06-08 |
| 1134743420 | Elizabeth Alden Mccants | Pediatrics | 125 Doughty St Ste 520d, Charleston, SC 29403-5736 | 2020-06-02 |
| 1770127516 | Nicole Danielle Clendenin | Pediatrics | 314 Goff Mountain Rd Ste 16, Charleston, WV 25313-6600 | 2019-11-05 |
| 1871059238 | Aminah Fraser- Abdur Rahim | Pediatrics | 1373 W Lenevar Dr, Charleston, SC 29407-5148 | 2019-02-11 |
| 1649632225 | Collin Dubick | Pediatrics | 1118 Sea Eagle Watch, Charleston, SC 29412-8249 | 2016-03-23 |
| 1417338781 | Heather Michelle Greene | Pediatrics | 169 Ashlet Avenue, Room 202 Main Hospital Msc 333, Charleston, SC 29425 | 2015-06-12 |
| 1780098160 | Matthew John Saia | Pediatrics | 2124 Telfair Way, Charleston, SC 29412-2370 | 2014-06-13 |
| 1770922601 | Lauren Simpson Tipton | Pediatrics | 1243 Savannah Hwy Ste B, Charleston, SC 29407-7817 | 2013-06-25 |
| 1467747527 | Pratikkumar Patel | Pediatrics | 830 Pennsylvania Ave Ste 401, Charleston, WV 25302-3390 | 2011-06-16 |
| 1245420058 | Christy Lynn Robinson | Pediatrics | 1538 Kanawha Blvd E, Charleston, WV 25311-2435 | 2007-07-27 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
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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.