Provider Demographics
NPI:1881244614
Name:OSBORNE, MEREDITH ELISE
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:ELISE
Last Name:OSBORNE
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 1:680 PELZER DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3556
Mailing Address - Country:US
Mailing Address - Phone:678-602-8195
Mailing Address - Fax:
Practice Address - Street 1:CHARLESTON THYROID CENTER
Practice Address - Street 2:1054 JOHNNIE DODDS BLVD, SUITE A
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464
Practice Address - Country:US
Practice Address - Phone:843-388-7545
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-13
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC04731363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPA-04731OtherPA LICENSE
FLTPPA797OtherPA LICENSE
VA0110010413OtherPA LICENSE