| Erica Dejesus | |
|
2100 Charlie Hall Blvd Charleston SC 29414-5832 | |
| (843) 852-4100 | |
| Not Available |
| Full Name | Erica Dejesus |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 2100 Charlie Hall Blvd, Charleston, South Carolina |
| Authorized Official Name and Position | Erica Dejesus (INTERN) |
| Authorized Official Contact | 8438524100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Erica Dejesus 2100 Charlie Hall Blvd Charleston SC 29414-5832 | Erica Dejesus 2100 Charlie Hall Blvd Charleston SC 29414-5832 Ph: (843) 852-4100 |
| NPI Number | 1326876517 |
|---|---|
| Provider Enumeration Date | 07/22/2024 |
| Last Update Date | 08/06/2024 |
| Certification Date | 08/06/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326876517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
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