Provider Demographics
NPI:1376597062
Name:TESSLER, STUART L (DPM)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:L
Last Name:TESSLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 MARKFIELD DR
Mailing Address - Street 2:STE 3
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7907
Mailing Address - Country:US
Mailing Address - Phone:843-571-0602
Mailing Address - Fax:843-571-0605
Practice Address - Street 1:60 MARKFIELD DR
Practice Address - Street 2:#3
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7907
Practice Address - Country:US
Practice Address - Phone:843-571-0602
Practice Address - Fax:843-571-0605
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC139213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T73556Medicare UPIN