Provider Demographics
NPI:1710380167
Name:GADSDEN, CHARON
Entity Type:Individual
Prefix:
First Name:CHARON
Middle Name:
Last Name:GADSDEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 CHURCH RD
Mailing Address - Street 2:
Mailing Address - City:SAINT STEPHEN
Mailing Address - State:SC
Mailing Address - Zip Code:29479-3397
Mailing Address - Country:US
Mailing Address - Phone:843-567-2035
Mailing Address - Fax:
Practice Address - Street 1:173 CHURCH RD
Practice Address - Street 2:
Practice Address - City:SAINT STEPHEN
Practice Address - State:SC
Practice Address - Zip Code:29479-3397
Practice Address - Country:US
Practice Address - Phone:843-567-2035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-30
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744P3200XOther Service ProvidersSpecialistProsthetics Case Management