OrganizationActive
Roper Hospital, Inc.
NPI 1487315164 · Undersea and Hyperbaric Medicine (Preventive Medicine) Physician · Moncks Corner, SC
Provider details
- NPI number
- 1487315164
- Entity type
- Organization
- Primary specialty
- Undersea and Hyperbaric Medicine (Preventive Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- William Jackson, Vp Coo(843) 839-1201
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3508 S Live Oak Dr Ste 200
Moncks Corner, SC 29461-8737
Phone: (843) 724-2289
Fax: (843) 606-8038
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 751649
Charlotte, NC 28275-1649
Other names (DBA / former)
- Doing business as
- Vascular Medicine and Wound Management Clinic
Registry dates
- Enumerated
- 2022-01-05
- Last updated
- 2024-03-17
- Certified
- 2024-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.