Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Port City Plastic Surgery, LLC

Organization Plastic and Reconstructive Surgery Physician · NPI 1437385788

Port City Plastic Surgery, LLC is a Plastic and Reconstructive Surgery Physician in North Charleston, South Carolina. Licensed in South Carolina. Registered with an NPI since 2009.

Licensed in
SC
In the registry since
2009
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

2683 Lake Park Dr
North Charleston, SC 29406-9100
Phone: (843) 518-5000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic and Reconstructive Surgery Physician (primary) Taxonomy 2086S0122X · Licence 200096 (SC)

Record details

NPI number1437385788
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brian Widenhouse — Owner · (843) 856-8398
NPI enumeratedJune 1, 2009
Last updated in NPPESMarch 9, 2017
Mailing address43 Woodford St, Daniel Island, SC 29492-7964

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