Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 810 | SC |
NPI | 1003000159 |
---|---|
Provider Name | Marsha Susan Voges |
First Address | Charleston, SC 29405 |
Second Address | Charleston, SC 29405 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2007 |
Last Update Date | 29/10/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
NP0404 | (05) | SC |
P099269295 | (02) | SC |
P099269295 | MEDICARE PTAN (01) | SC |