Brian Edward Lally, MD
in Charleston, SC. Individual provider (NPI-1).
NPI number1114102407
StatusActive
Last updated in NPPESSep 7, 2023
Details
- NPI
- 1114102407
- Entity type
- Individual (NPI-1)
- Name
- Brian Edward Lally
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 4, 2008
- Certification date
- Sep 7, 2023
- Last updated
- Sep 7, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2085R0001X | 89973 | SC | Yes | |
| 2085R0001X | MD423422 | PA |
Practice location
171 Ashley AveCharleston, SC 29425-5127
Phone 843-792-1414
Mailing address
Po Box 751461Charlotte, NC 28275-1461
Phone 843-792-6200
Other practice locations
3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Philadelphia, PA 19104-5127
Phone 215-662-4853
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