Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | 39376 | SC |
NPI | 1013203959 |
---|---|
Provider Name | Lauren Rittenberg |
First Address | Charlotte, NC 28275-1649 |
Second Address | Mt Pleasant, SC 29464-1812 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2011 |
Last Update Date | 27/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
393764 | (05) | SC |