Provider Demographics
NPI:1770687063
Name:HULL, DENNIS MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:MICHAEL
Last Name:HULL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9295 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29406-9137
Mailing Address - Country:US
Mailing Address - Phone:843-797-3960
Mailing Address - Fax:843-553-4216
Practice Address - Street 1:9295 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE B
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-9137
Practice Address - Country:US
Practice Address - Phone:843-797-3960
Practice Address - Fax:843-553-4216
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC7845207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC078454Medicaid
SCP00395296OtherMEDICARE RAILROAD
SCP00395296OtherMEDICARE RAILROAD