Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 2016011872 | MO |
Y | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 40692 | SC |
NPI | 1306130307 |
---|---|
Provider Name | Dr. Dustin S Hambright |
First Address | N Charleston, SC 29406-9167 |
Second Address | N Charleston, SC 29406-9167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2011 |
Last Update Date | 17/03/2018 |