Dr. Alisa Nicole Blumenthaler, MD
Surgery, Surgical Oncology in Charleston, SC. Individual provider (NPI-1).
NPI number1982124418
StatusActive
Last updated in NPPESAug 11, 2025
Details
- NPI
- 1982124418
- Entity type
- Individual (NPI-1)
- Name
- Dr. Alisa Nicole Blumenthaler
- Credential
- MD
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 26, 2017
- Certification date
- Aug 11, 2025
- Last updated
- Aug 11, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2086X0206X | Surgery, Surgical Oncology | 95272 | SC | Yes |
| 2086X0206X | Surgery, Surgical Oncology | A194546 | CA | |
| 390200000X | Student in an Organized Health Care Education/Training Program | 11019543A | IN |
Practice location
Department Of Surgery 30 Courtenay Drive Msc 295Charleston, SC 29425-1810
Phone 843-792-1414
Mailing address
Po Box 751461Charlotte, NC 28275-1461
Phone 843-792-1414
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