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Contact Information

SOUTHEAST WOUND SPECIALISTS, LLC
9302 MEDIAL PLAZA DRIVE
SUITE A
CHARLESTON, SC29406-9142
 Phone: 912-232-9700
 Fax: 912-748-0270
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Emergency Medicine

207P00000X 93 Physician/Emergency Medicine
 

Undersea and Hyperbaric Medicine

207PE0005X 93 Physician/Emergency Medicine
Indicates primary specialty

NPI Profile & details for SOUTHEAST WOUND SPECIALISTS, LLC

NPI Number 1114953742
LBN Legal business name SOUTHEAST WOUND SPECIALISTS, LLC
Authorized official TIMOTHY GREGORY - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/24/2006
Last updated 07/21/2022 - About 4 years ago
Identifiers
GA Medicaid 013997
SC Medicaid GP4454
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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