Organization Active NPI

David D. Egleston MD, PA

  • Adult Medicine Physician
  • Charleston, SC
National Provider Identifier
1821268384
Registry record updated May 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
DAVID D. EGLESTON MD, PA
Practice address
418 Folly Rd
Suite a
Charleston, SC 29412-2625
Phone
(843) 795-5362
Fax
(843) 795-1921
NPI assigned
Mar 11, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2008

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

Authorized official

Name
Dr. David D. Egleston, MD
Title
President
Phone
(843) 795-5362

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

418 Folly Rd
Suite a
Charleston, SC 29412-2625

Mailing address

418 Folly Rd
Suite a
Charleston, SC 29412-2625
Phone (843) 795-5362

Other identifiers 1

IdentifierTypeStateIssuer
070568MedicaidSC

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211241600000",
    "number": "1821268384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 FOLLY RD",
            "address_2": "SUITE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122625",
            "telephone_number": "843-795-5362",
            "fax_number": "843-795-1921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 FOLLY RD",
            "address_2": "SUITE A",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294122625",
            "telephone_number": "843-795-5362",
            "fax_number": "843-795-1921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID D. EGLESTON MD, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2008-05-20",
        "status": "A",
        "authorized_official_last_name": "EGLESTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "843-795-5362",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "070568",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; 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.