Charleston Blood Disorders & Cancer Center, P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

20-11042 Issued in SC

Legal business name

CHARLESTON BLOOD DISORDERS & CANCER CENTER, P.A.

Practice address

2093 Henry Tecklenburg Drive Suite318E
Charleston, SC 29414

Phone

(843) 582-0266

Fax

(843) 852-2025

NPI assigned

Sep 28, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Robert T Wall Jr., M.D.

Title

Owner

Phone

(843) 852-0266

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279670400000",
    "number": "1225120264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2093 HENRY TECKLENBURG DRIVE SUITE318E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-582-0266",
            "fax_number": "843-852-2025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2093 HENRY TECKLENBURG DRIVE SUITE318E",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29414",
            "telephone_number": "843-582-0266",
            "fax_number": "843-852-2025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLESTON BLOOD DISORDERS & CANCER CENTER, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-28",
        "last_updated": "2010-07-21",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "843-852-0266",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "SC",
            "license": "20-11042",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP3633",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jane M Charles, MD
• Ludny Charles, MD
• Charleston Acupuncture
• Charleston Anesthesia Group LLC
• Charleston Billing Solutions, LLC
• Charleston Bone & Joint PA
• Charleston Bone & Joint PA
• Charleston Brace Company, LLC
• Charleston Breast Center, Inc.
• Charleston Care Rides LLC

• Specialist in Charleston, SC
• Providers in Charleston, SC by specialty
• Specialist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.