Intaphan, Jared M
Intaphan, Jared M is an sole proprietor health care provider with primary practice located at 9150 Medcom St Ste B , North Charleston SC 29406. He recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Critical Care Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease, Allopathic & Osteopathic Physicians / Sleep Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Pulmonary Disease is his primary health care specialty. Intaphan, Jared M can be contacted via phone (843) 572-3330.Contact Information
Primary practice address
9150 Medcom St Ste B
North Charleston SC 29406
Phone: (843) 572-3330
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD39445 | South Carolina |
| Allopathic & Osteopathic Physicians / Critical Care Medicine | 207RC0200X | MD39445 | South Carolina |
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | MD39455 | South Carolina |
| Allopathic & Osteopathic Physicians / Sleep Medicine | 207RS0012X | MD39445 | South Carolina |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Pulmonary Disease | 207RP1001X | MD39445 | South Carolina |
Profile Details
| NPI number | 1639486160 |
|---|---|
| LBN Legal business name | Intaphan, Jared M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 3rd, 2010 |
| Last updated | Jun 2nd, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1639486160 | NPPES |
| South Carolina | MEDICAID | 394451 |
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