Clark, Erica Rousseau

Clark, Erica Rousseau is an individual health care provider with primary practice located at 225 E Wood St , Spartanburg SC 29303-3050. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is her primary health care specialty. Clark, Erica Rousseau can be contacted via phone (864) 560-4420.

Contact Information

Primary practice address
225 E Wood St Spartanburg SC 29303-3050
Phone: (864) 560-4420
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X 4772 South Carolina
Allopathic & Osteopathic Physicians / Vascular Surgery 2086S0129X 4772 South Carolina

Profile Details

NPI number 1255635389
LBN Legal business name Clark, Erica Rousseau
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2011
Last updated Dec 10th, 2020 - about 4 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255635389 NPPES
South Carolina MEDICAID 047728
South Carolina MEDICAID Q027415
South Carolina Other SCG3105019
South Carolina Other SCG3103365
South Carolina Other SCG3109225

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