David J Annibale, MD
Individual provider Active NPI Neonatal-Perinatal Medicine Physician · Charleston, SC
NPI 1497863443 · NPPES record last updated Sep 19, 2011
Key facts
- NPI
- 1497863443
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neonatal-Perinatal Medicine Physician 2080N0001X
- License
- 14407 (SC)
- Practice address
- 171 Ashley Ave
Charleston, SC 29425-0001 - Phone
- (843) 792-1414
- NPI assigned
- Aug 29, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 4
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in SC
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090313000385 | SC | Practitioner - Pediatric Medicine | 8729144910 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14407 | SC | MD | Neonatal-Perinatal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University Medical Associates of the Medical University of South Carol | Current |
Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current | Accepting new patients | |
| University Medical Associates of the Medical University of South Carol | Current |
Accepting new patients | |
| Medical University Hospital Authority | Past | Accepting new patients |
Locations
10 McClennan Banks Dr
Charleston, SC 29401
Phone (843) 330-9824
171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neonatal-Perinatal Medicine Physician | 2080N0001X | 14407 | SC | Yes |
Addresses
Primary practice location
171 Ashley Ave
Charleston, SC 29425-0001
Mailing address
PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-6200
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144070 | Medicaid | SC |
Other providers in Charleston, SC
- Anisha Gulati MD LLC
- Misbha Anjum
- Ali Annaim
- Anne C Epting MD PA
- Annette Bilton Anderson, MD
- James Francis Anoia
- Katherine Antel
- Margaret Teresa Anton
- Raymond Francis Anton Jr.
- Elizabeth Braden Schmidt Antonio
All providers in Charleston, SC · Neonatal-Perinatal Medicine Physician 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 Sep 19, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.