Henry Othersen JR.
Pediatric Surgery
171 Ashley Ave
Charleston
, South Carolina 29425-0001
Henry Othersen JR.
Pediatric Surgery
171 Ashley Ave
Charleston
, South Carolina 29425-0001
(843) 792-6200
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About
Features
Specialties
- Pediatric Surgery
Languages spoken
- English
Location
First Address
- Henry Othersen JR.
- Po Box 751461
- Charlotte, NC
- Zip : 28275-1461
- Phone : (843) 792-6200
Second Address
- Henry Othersen JR.
- 171 Ashley Ave
- Charleston, SC
- Zip : 29425-0001
- Phone : (843) 792-1414
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FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2086S0120X | Pediatric Surgery | 3602 | SC |
National Provider Identifier
| NPI | 1073628913 |
|---|---|
| Provider Name | Henry Othersen JR. |
| First Address | Charlotte, NC 28275-1461 |
| Second Address | Charleston, SC 29425-0001 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/08/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036026 | (05) | SC |
| B92091 | (02) | SC |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.