Runey, Justin Tyler

Runey, Justin Tyler is an individual health care provider with primary practice located at 2880 Tricom St , North Charleston SC 29406-9171. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Surgical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is his primary health care specialty. Runey, Justin Tyler can be contacted via phone (843) 797-5050.

Contact Information

Primary practice address
2880 Tricom St North Charleston SC 29406-9171
Phone: (843) 797-5050
Fax: (843) 797-3633
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA 1842 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA 1842 South Carolina

Profile Details

NPI number 1336490739
LBN Legal business name Runey, Justin Tyler
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 25th, 2012
Last updated Mar 13th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336490739 NPPES
South Carolina MEDICAID 1874PA
South Carolina Other P01337423
South Carolina Other DU4331
South Carolina Other GP6337
South Carolina Other D043
South Carolina Other 1902246077

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