Provider First Line Business Practice Location Address:
MEDICAL UNIVERSITY OF SOUTH CAROLINA
Provider Second Line Business Practice Location Address:
114 DOUGHTY STREET SUITE 654
Provider Business Practice Location Address City Name:
CHARLESTON
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29424-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
843-876-4854
Provider Business Practice Location Address Fax Number:
843-876-4413
Provider Enumeration Date:
06/09/2010