Ettaleah Bluestein M.D.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

15521 Issued in SC

Legal business name

ETTALEAH BLUESTEIN M.D.

Practice address

2287 Henry Tecklenburg Dr
Suite 1
Charleston, SC 29414-7801

Phone

(843) 769-6655

Fax

(843) 769-6866

NPI assigned

May 17, 2006

Organization subpart

No

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

Authorized official

Name

Ettaleah Bluestein, M.D.

Title

Doctor

Phone

(843) 769-6655

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Edward Thompson III, MD

  • Ophthalmology Physician
  • Ladson, SC
  • NPI 1447299771
  NPD (past)

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1362355200000",
    "number": "1720030836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2287 HENRY TECKLENBURG DR",
            "address_2": "SUITE 1",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-769-6655",
            "fax_number": "843-769-6866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2287 HENRY TECKLENBURG DR",
            "address_2": "SUITE 1",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294147801",
            "telephone_number": "843-769-6655",
            "fax_number": "843-769-6866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETTALEAH BLUESTEIN M.D.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2013-03-04",
        "status": "A",
        "authorized_official_last_name": "BLUESTEIN",
        "authorized_official_first_name": "ETTALEAH",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "843-769-6655",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "SC",
            "license": "15521",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP4400",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Anne Estupinan-Kane, PH.D.
• Eterna Aesthetics and Wellness
• William Etheridge, PA-C
• Emma Ethredge
• Landrie H. Ethredge, M.A.
• Jessica Etten, NP
• Julie Etters
• Adarsh Reddy Ettyreddy, MD
• James Edward Eubanks Jr., MD
• Eunoia LTD Co

• Ophthalmology Physician in Charleston, SC
• Providers in Charleston, SC by specialty
• Ophthalmology Physician in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2013; 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.