Redge, Susan Barbara

Redge, Susan Barbara is an individual health care provider with primary practice located at 164 Waccamaw Medical Park Dr , Conway SC 29526-8903. She recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as her primary health care specialty. Redge, Susan Barbara can be contacted via phone (843) 347-5060.

Contact Information

Primary practice address
164 Waccamaw Medical Park Dr Conway SC 29526-8903
Phone: (843) 347-5060
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 27527 South Carolina
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 4301072829 Michigan

Profile Details

NPI number 1710906805
LBN Legal business name Redge, Susan Barbara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 19th, 2006
Last updated Feb 7th, 2013 - about 12 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 1710906805 NPPES
South Carolina MEDICAID 327877

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