Dr. Charles E. Corley MD
Full Name
Dr. Charles E Corley MD
NPI Number
1053497750
NPI Type
Individual Provider
Gender
Male
Enumeration Date
10/27/2006
Specialties
(Taxonomies)Name
Code
207L00000X
207LC0200X
207LP2900X
Primary Taxonomy
No
No
No
Licenses
State
South Carolina
License Number
5061
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 2344
2720 SUNSET BLVD
City
Columbia
West Columbia
State
SC
SC
Postal Code
29202-2344
29169-4810
Country
US
US
Telephone Number
(803) 254-2394
(803) 254-2394
Identifiers
Identifier
050615
2020123
77786
050615
5231504
Identifier State
SC
SC
SC
SC
SC
Identifier Issuer
Unknown
CCP
MEDCOST
SELECT HEALTH
AETNA
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/08/2007