Provider Demographics
NPI:1154300424
Name:HASKINS, CURTIS D (MD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:D
Last Name:HASKINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 SAM RITTENBERG BLVD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-3362
Mailing Address - Country:US
Mailing Address - Phone:843-556-3462
Mailing Address - Fax:843-766-2103
Practice Address - Street 1:418 FOLLY RD STE A
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412-2625
Practice Address - Country:US
Practice Address - Phone:843-795-5362
Practice Address - Fax:843-795-1921
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2019-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC15474207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC080077152OtherRR MEDICARE
SCP00797258OtherRAILROAD MC ID-RSFPN
SC154745Medicaid
SC080180693OtherRR MEDICARE
SCE91151A634OtherMEDICARE PIN
SC154745Medicaid
SC080077152OtherRR MEDICARE
SCE911515004Medicare PIN
SCE91151Medicare UPIN