Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 23234 | SC |
Y | 2080P0216X | Pediatric Rheumatologist | 23234 | SC |
NPI | 1447286836 |
---|---|
Provider Name | Natasha Mckerran Ruth |
First Address | Charlotte, NC 28275-1461 |
Second Address | Charleston, SC 29425-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/06/2006 |
Last Update Date | 01/12/2015 |