Quattlebaum, Thomas Godfrey

Quattlebaum, Thomas Godfrey is an individual health care provider with primary practice located at 198 Rutledge Ave Suite 1, Charleston SC 29403-5817. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Quattlebaum, Thomas Godfrey can be contacted via phone (843) 723-0855.

Contact Information

Primary practice address
198 Rutledge Ave Suite 1 Charleston SC 29403-5817
Phone: (843) 723-0855
Fax: (843) 723-1307
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 7831 South Carolina

Profile Details

NPI number 1669430724
LBN Legal business name Quattlebaum, Thomas Godfrey
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 1st, 2006
Last updated Aug 13th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669430724 NPPES
South Carolina MEDICAID 078310

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