Provider Demographics
NPI:1548759780
Name:CHARLESTON THYROID CENTER, LLC
Entity type:Organization
Organization Name:CHARLESTON THYROID CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:DR
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:BOHINC
Authorized Official - Last Name:HENDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-388-7545
Mailing Address - Street 1:1054 JOHNNIE DODDS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3153
Mailing Address - Country:US
Mailing Address - Phone:843-388-7545
Mailing Address - Fax:843-388-5548
Practice Address - Street 1:1054 JOHNNIE DODDS BLVD STE A
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3153
Practice Address - Country:US
Practice Address - Phone:843-388-7545
Practice Address - Fax:843-388-5548
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2019-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Multi-Specialty