Richardson, Mary

Richardson, Mary is an individual health care provider with primary practice located at 171 Ashley Ave , Charleston SC 29425-0001. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anatomic Pathology, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is her primary health care specialty. Richardson, Mary can be contacted via phone (843) 792-1414.

Contact Information

Primary practice address
171 Ashley Ave Charleston SC 29425-0001
Phone: (843) 792-1414
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology 207ZP0101X 16441 South Carolina
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 16441 South Carolina

Profile Details

NPI number 1780608604
LBN Legal business name Richardson, Mary
Credentials DDS, MD
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Oct 20th, 2020 - about 5 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 1780608604 NPPES
South Carolina MEDICAID 164413

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