Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 41007 | SC |
Y | 208600000X | Surgeon | 41007 | SC |
NPI | 1003344110 |
---|---|
Provider Name | Dr. Michael Charles O'laughlin |
First Address | Charleston, SC 29425 |
Second Address | Charleston, SC 29425 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2017 |
Last Update Date | 05/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
LL41007 | (05) | SC |