Self, Sally
Self, Sally is an individual health care provider with primary practice located at 171 Ashley Ave , Charleston SC 29425-0001. She recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as her primary health care specialty. Self, Sally can be contacted via phone (843) 792-1414.Contact Information
Primary practice address
171 Ashley Ave
Charleston SC 29425-0001
Phone: (843) 792-1414
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 9365 | South Carolina |
Profile Details
| NPI number | 1417978388 |
|---|---|
| LBN Legal business name | Self, Sally |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 23rd, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1417978388 | NPPES |
| South Carolina | MEDICAID | 093650 |
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