Provider Demographics
NPI:1982037529
Name:CHARLESTON ADDICTION MEDICINE, LLC
Entity Type:Organization
Organization Name:CHARLESTON ADDICTION MEDICINE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:HUGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:678-641-4086
Mailing Address - Street 1:4255 FABER PLACE DR
Mailing Address - Street 2:UNIT 403
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405-8574
Mailing Address - Country:US
Mailing Address - Phone:678-641-4086
Mailing Address - Fax:
Practice Address - Street 1:2175 ASHLEY PHOSPHATE RD
Practice Address - Street 2:SUITE G
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29406-4181
Practice Address - Country:US
Practice Address - Phone:843-225-8406
Practice Address - Fax:843-225-8410
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-19
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC189762084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction MedicineGroup - Single Specialty