Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | R49175 | SC |
NPI | 1104044213 |
---|---|
Provider Name | Ms. Karen A Rushford |
First Address | Conway, SC 29526-9154 |
Second Address | Conway, SC 29526-9154 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
P19319 | (02) | SC |