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TIDEWATER DOCTORS LLC NPI 1821769290


NPI Information

NPI: 1821769290
Provider Name: TIDEWATER DOCTORS LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 42D2145618

Address:
2270 ASHLEY CROSSING DR STE 155
CHARLESTON, SC
ZIP 29414
Phone: (843) 990-5866
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TIDEWATER DOCTORS LLC is an internal medicine in Charleston, SC. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. TIDEWATER DOCTORS LLC NPI is 1821769290. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2270 ASHLEY CROSSING DR STE 155
CHARLESTON, SC
ZIP 29414-749
Phone: (843) 990-5866
Fax: (843) 868-8041

The provider's authorized official is Andrea Hurley .
The authorized official title is Practice Administrator and has the following contact phone number (843) 200-7721.

The CLIA number assigned to this NPI record is 42D2145618 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/24/2021 and was last updated on 9/24/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineNo
2207R00000XInternal MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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