CHARLES MEDLOCK PROCTOR (NPI# 1740418359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740418359 |
| Entity Type | Individual |
| Full Name | CHARLES MEDLOCK PROCTOR |
| Credential | M.D. |
| Practice Address |
171 Ashley Ave Charleston SC 29425-8908 |
| Mailing Address |
Po Box 751461 Charlotte NC 28275-1461 |
| Practice Telephone | 8437922300 |
| Mailing Telephone | 8437926200 |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2013-06-14 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207W00000X | Ophthalmology | LL31908 | SC | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700376092 | Charles Nelson Proctor Iv | Student in an Organized Health Care Education/Training Program | 300 2nd Ave, Long Branch, NJ 07740-6303 | 2018-05-13 |
| Street Address |
171 ASHLEY AVE |
| City | CHARLESTON |
| State | SC |
| Zip Code | 29425-8908 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942203922 | Nicholas J Pastis Jr. | Internal Medicine | 171 Ashley Ave, Charleston, SC 29425-8900 | 2005-05-24 |
| 1760083745 | Eleta Lazar Donelan | Physician Assistant | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-11-05 |
| 1285231340 | Bree Romecki | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-10-02 |
| 1942812078 | Warren Allen James | Student in an Organized Health Care Education/Training Program | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-19 |
| 1457962060 | Rosmary Ros-demarize | Psychologist | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-08-17 |
| 1558971390 | Auryelle Ascue | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-08-06 |
| 1396361994 | David Gonzalez | Nurse Practitioner | 171 Ashley Ave, Charleston, SC 29425-8911 | 2020-06-19 |
| 1003432592 | Hannah Burrick | Audiologist | 171 Ashley Ave, Charleston, SC 29425-8903 | 2020-06-19 |
| 1528683562 | Kelsey Renee Full | Emergency Medicine | 171 Ashley Ave, Charleston, SC 29425-0100 | 2020-06-16 |
| 1861017949 | Christina Lee | Anesthesiology | 171 Ashley Ave, Charleston, SC 29425-8908 | 2020-06-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922607217 | Krishna Bhandari | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 10 Mcclennan Banks Drive, 2190-r, Msc 918, Charleston, SC 29425 | 2020-10-19 |
| 1649892456 | Mary Macrae Lynch | Social Worker | 179 Ashley Avenue, Charleston, SC 29425 | 2020-05-14 |
| 1528600053 | Amanda Watts | Physician Assistant | 135 Rutledge Ave. Msc 561, Charleston, SC 29425 | 2019-10-16 |
| 1851945497 | Kacy Wonder | Dentist | 173 Ashley Avenue Room 453 Msc 507, Charleston, SC 29425 | 2019-08-01 |
| 1477114569 | Justin Robert Silverman | Surgery | 169 Ashley Avenue, Room 202 Muh, Msc 333, Charleston, SC 29425 | 2019-06-28 |
| 1740840024 | Tyler Buckley | Surgery | 169 Ashley Ave, Room 202 Main Hospital, Msc333, Charleston, SC 29425 | 2019-06-18 |
| 1366001760 | Rayphael Sebastian Hardy | Internal Medicine | 169 Ashley Avenue Room 202 Main Hospital Msc333, Charleston, SC 29425 | 2019-06-10 |
| 1437718889 | Samar Medani | Internal Medicine | Division of Nephrology, Medical Univ of South Carolina, 96 Jonathan Lucas Street, Room 822, Msc 629, Charleston, SC 29425 | 2019-06-10 |
| 1427617950 | Emily Suzanne Nyers | Internal Medicine | 169 Ashley Ave., Room 202 Main Hospital, Msc 333, Charleston, SC 29425 | 2019-06-09 |
| 1790343564 | Alan Cowei Peh | Psychiatry & Neurology | 169 Ashley Avenue Rm 202, Main Hospital Msc 333, Charleston, SC 29425 | 2019-06-05 |
| Find all providers in zip 29425 | ||||
| Taxonomy Code | 207W00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Ophthalmology |
| An ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Ophthalmology, 2007. http://www.abop.org/. American Osteopathic Board of Ophthalmology and Otolaryngology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Ophthalmology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568915619 | Susannah Liberty Brown | Ophthalmology | 167 Ashley Ave Rm 503, Charleston, SC 29425-3098 | 2016-07-25 |
| 1972813996 | Joseph Jefferds Sinclair Md Pllc | Ophthalmology | 500 Lee St E, Suite 150, Charleston, WV 25301-3200 | 2010-10-08 |
| 1487886628 | Moseley Hubbard Winkler | Ophthalmology | 105 Whispering Woods Rd, Charleston, WV 25304-2740 | 2009-08-21 |
| 1710180534 | Scott Conrad Jamerson | Ophthalmology | 331 Laidley St., Suite 301, Charleston, WV 25339-3970 | 2007-06-08 |
| 1487875266 | Minardi Eye Center, Inc. | Ophthalmology | 500 Donnally St Bldg B, Charleston, WV 25301-1648 | 2007-05-01 |
| 1902826571 | Robert E Peyser | Ophthalmology | 1637 Savannah Hwy, Charleston, SC 29407-6282 | 2006-07-19 |
| 1962446427 | Lowrey Pearson King | Ophthalmology | 2057 Charlie Hall Blvd, Ste. A, Charleston, SC 29414-5834 | 2006-06-15 |
| 1548203185 | Michael Johnson | Ophthalmology | 3531 Mary Ader Ave Ste D, Charleston, SC 29414-5896 | 2006-06-13 |
| 1912940735 | Budev Eyecare & Surgery, Pa | Ophthalmology | 2093 Henry Tecklenburg Drive, Ste 313, Charleston, SC 29414 | 2006-06-13 |
| 1356382675 | James White Caudill | Ophthalmology | 501 Summers St, Charleston, WV 25301-1239 | 2006-06-09 |
| Find all providers in CHARLESTON | ||||
| City | CHARLESTON |
| Zip Code | 29425 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.