Carolina Gastroenterology & Nutrition Clinics, LLC
Organization Active NPI Specialist · Charleston, SC
NPI 1063680197 · NPPES record last updated Aug 21, 2018
Key facts
- NPI
- 1063680197
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialist 174400000X
- License
- 8659 (SC)
- Legal business name
- CAROLINA GASTROENTEROLOGY & NUTRITION CLINICS, LLC
- Practice address
- 102 Wappoo Creek Dr Ste 10C
Charleston, SC 29412 - Phone
- (843) 762-9321
- Fax
- (843) 377-1580
- NPI assigned
- Feb 12, 2008
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles Allen Bickerstaff Jr., M.D.
- Title
- Physician
- Phone
- (843) 762-9321
Practitioners 2
-
Barbara Ellen Magera, MD, PHARM. D
National Provider Directory
Locations
102 Wappoo Creek Dr
Ste 10C
Charleston, SC 29412
Phone (843) 762-9321
219 N Highway 52
Ste E
Moncks Corner, SC 29461
Phone (843) 761-8795
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist |
174400000X | 8659 | SC | Yes |
Addresses
Primary practice location
102 Wappoo Creek Dr Ste 10C
Charleston, SC 29412
Mailing address
102 Wappoo Creek Dr Ste 10C
Charleston, SC 29412-2144
Phone (843) 762-9321
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 086597 | Medicaid | SC |
Other providers in Charleston, SC
- Carolina Family Care, Inc
- Carolina Family Care, Inc
- Carolina Family Care, Inc
- Carolina Family Care, Inc
- Carolina Foot & Ankle Specialists, LLC
- Carolina Hand Therapy Inc
- Carolina Hand Therapy Inc
- Carolina Health Force
- Carolina Hearing Services, Inc.
- Carolina Homeless Veterans, Inc
All providers in Charleston, SC · Specialist in South Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 21, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.