Basic Information
| Provider Information | |||||||||
| NPI: | 1417047333 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUIET | ||||||||
| FirstName: | CHRISTOPER | ||||||||
| MiddleName: | D. | ||||||||
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| Credential: | P.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3239 | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295023239 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437777097 | ||||||||
| FaxNumber: | 8437777102 | ||||||||
| Practice Location | |||||||||
| Address1: | 1005 E CHEVES ST | ||||||||
| Address2: | |||||||||
| City: | FLORENCE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 295062707 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437777900 | ||||||||
| FaxNumber: | 8437777102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/13/2006 | ||||||||
| LastUpdateDate: | 02/03/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/03/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | 646 | SC | N | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | 363AS0400X | 646 | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Surgical |
ID Information
| ID | Type | State | Issuer | Description | P00385490 | 01 | SC | RR MEDICARE | OTHER | 0474PA | 05 | SC | MEDICAID | 576007863178 | 01 | SC | BCBS OF SC | OTHER |