Provider First Line Business Practice Location Address: 
MUSC HEMATOLOGY ONCOLOGY
    Provider Second Line Business Practice Location Address: 
86 JONATHAN LUCAS ST., MSC 635
    Provider Business Practice Location Address City Name: 
CHARLESTON
    Provider Business Practice Location Address State Name: 
SC
    Provider Business Practice Location Address Postal Code: 
29425-8908
    Provider Business Practice Location Address Country Code: 
US
    Provider Business Practice Location Address Telephone Number: 
843-792-6200
    Provider Business Practice Location Address Fax Number: 
    Provider Enumeration Date: 
01/29/2008