Provider Demographics
NPI:1689728123
Name:CHARLESTOWNE INTERNAL MEDICINE
Entity Type:Organization
Organization Name:CHARLESTOWNE INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:
Authorized Official - Last Name:POSTELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-744-1669
Mailing Address - Street 1:3531 MARY ADER AVE
Mailing Address - Street 2:BUILDING A
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-5896
Mailing Address - Country:US
Mailing Address - Phone:843-744-1669
Mailing Address - Fax:843-769-9971
Practice Address - Street 1:3531 MARY ADER AVE
Practice Address - Street 2:BUILDING A
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5896
Practice Address - Country:US
Practice Address - Phone:843-744-1669
Practice Address - Fax:843-769-9971
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-22
Last Update Date:2007-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1298Medicaid
SC7346Medicare PIN