Provider Demographics
NPI:1043206410
Name:HURLEY, DONALD P (DO)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:P
Last Name:HURLEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2834 AQUADUCT ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-7410
Mailing Address - Country:US
Mailing Address - Phone:843-766-1936
Mailing Address - Fax:843-766-1206
Practice Address - Street 1:2270 ASHLEY CROSSING DR STE 150
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-5702
Practice Address - Country:US
Practice Address - Phone:843-766-1936
Practice Address - Fax:843-766-1206
Is Sole Proprietor?:No
Enumeration Date:2005-09-21
Last Update Date:2021-09-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
SCSC0310207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC3105Medicaid
SCGP3558Medicaid
SC043611743OtherFEDERAL ID NUMBER
SCGP3558Medicaid
SCSC5935A634Medicare PIN