Individual provider · Type 1 NPI

Justin Tyler Runey, PA-C

Surgical Physician Assistant · Charleston, SC

NPI number 1336490739 Active

Practice location

2093 Henry Tecklenburg Dr Ste 200E
Charleston, SC 29414-5742

Call (843) 958-2500 Map

Fax (843) 958-2680

Mailing address

PO Box 632709
Cincinnati, OH 45263-2709

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA 1842 (SC)
Medical Physician Assistant 363AM0700XPA 1842 (SC)

Surgical Physician Assistant: Definition to come...

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About NPI 1336490739

Justin Tyler Runey, PA-C's National Provider Identifier is 1336490739, issued on Sep 25, 2012. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Charleston, SC. The record was last updated on Oct 19, 2026.