Provider Demographics
NPI:1124387246
Name:TELE, SHRIKANT (MD)
Entity type:Individual
Prefix:DR
First Name:SHRIKANT
Middle Name:
Last Name:TELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 WOODFORD ST
Mailing Address - Street 2:
Mailing Address - City:DANIEL ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29492-8046
Mailing Address - Country:US
Mailing Address - Phone:843-606-0001
Mailing Address - Fax:270-249-4087
Practice Address - Street 1:3647 MAYBANK HWY
Practice Address - Street 2:
Practice Address - City:JOHNS ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29455-4825
Practice Address - Country:US
Practice Address - Phone:843-606-0001
Practice Address - Fax:270-249-4087
Is Sole Proprietor?:No
Enumeration Date:2012-05-09
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD457047208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation