Most Relevant Information
Provider Data
| NPI Number: | 1003435504 |
| Provider Name: | CHARLES POPHAL MD |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 04/14/2020 |
| Last Updated: | 06/28/2021 |
Provider Practice Location
171 ASHLEY AVE
CHARLESTON
SC
294251436
Practice Location Phone/Fax
| Phone: | 3303753315 |
| Fax: |
Provider Mailing Location
171 ASHLEY AVE
CHARLESTON
SC
294258908
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |