Provider Demographics
NPI:1851431084
Name:WHITFIELD, CHARLES L JR (AUD)
Entity Type:Individual
Prefix:MR
First Name:CHARLES
Middle Name:L
Last Name:WHITFIELD
Suffix:JR
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208A EAST 2ND NORTH ST.
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483
Mailing Address - Country:US
Mailing Address - Phone:843-871-9669
Mailing Address - Fax:843-871-8197
Practice Address - Street 1:208A EAST 2ND NORTH ST.
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483
Practice Address - Country:US
Practice Address - Phone:843-871-9669
Practice Address - Fax:843-871-8197
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-191231H00000X
SC3903231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist