Provider Demographics
NPI:1538435847
Name:FOCUS.MD-SC 1001
Entity type:Organization
Organization Name:FOCUS.MD-SC 1001
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:704-804-1901
Mailing Address - Street 1:8045 PROVIDENCE RD
Mailing Address - Street 2:SUITE 325
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28277-8745
Mailing Address - Country:US
Mailing Address - Phone:704-804-1901
Mailing Address - Fax:704-341-9996
Practice Address - Street 1:1300 HOSPITAL DR
Practice Address - Street 2:SUITE 310
Practice Address - City:MT PLEASANT
Practice Address - State:SC
Practice Address - Zip Code:29464-3261
Practice Address - Country:US
Practice Address - Phone:843-737-6030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty