Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0216X | Pediatric Rheumatologist | 011544E | PA |
NPI | 1669790267 |
---|---|
Provider Name | Dr. Judith Carolyn Anderson |
First Address | Isle Of Palms, SC 29451-2714 |
Second Address | Isle Of Palms, SC 29451-2714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2010 |
Last Update Date | 07/05/2010 |