Provider Demographics
NPI:1184132193
Name:SOUTH CAROLINA NEURO, LLC
Entity type:Organization
Organization Name:SOUTH CAROLINA NEURO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:HOWARD
Authorized Official - Last Name:BUDDIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:PHD
Authorized Official - Phone:843-860-5266
Mailing Address - Street 1:29 LEINBACH DRIVE
Mailing Address - Street 2:D4
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29407-7086
Mailing Address - Country:US
Mailing Address - Phone:843-509-6521
Mailing Address - Fax:843-636-3406
Practice Address - Street 1:29 LEINBACH DRIVE
Practice Address - Street 2:D4
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-7086
Practice Address - Country:US
Practice Address - Phone:843-509-6521
Practice Address - Fax:843-636-3406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-12
Last Update Date:2021-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Single Specialty