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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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