Etheridge, John Bruce

Etheridge, John Bruce is an individual health care provider with primary practice located at 2781 Tricom Street , Charleston SC 29406-9170. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Etheridge, John Bruce can be contacted via phone (843) 797-5600.

Contact Information

Primary practice address
2781 Tricom Street Charleston SC 29406-9170
Phone: (843) 797-5600
Fax: (843) 572-4872
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 19936 South Carolina

Profile Details

NPI number 1861586414
LBN Legal business name Etheridge, John Bruce
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 3rd, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1861586414 NPPES
South Carolina MEDICAID 199369

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