Etheridge, Tricia L

Etheridge, Tricia L is an sole proprietor health care provider with primary practice located at 109 S Green St , Ridgeland SC 29936-9165. She recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as her primary health care specialty. Etheridge, Tricia L can be contacted via phone (843) 726-6773.

Contact Information

Primary practice address
109 S Green St Ridgeland SC 29936-9165
Phone: (843) 726-6773
Fax: (843) 726-6778
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X 19547 South Carolina

Profile Details

NPI number 1366531162
LBN Legal business name Etheridge, Tricia L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2006
Last updated Dec 14th, 2015 - about 11 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 1366531162 NPPES
South Carolina Other 320114664 BLUE CROSS BLUE SHIELD
South Carolina Other 42D1028556 BLUE CROSS BLUE SHIELD
South Carolina Other DC4084 BLUE CROSS BLUE SHIELD
South Carolina Other 320114664 BLUE CROSS BLUE SHIELD
South Carolina Other 19547 BLUE CROSS BLUE SHIELD
South Carolina MEDICAID L25587 BLUE CROSS BLUE SHIELD

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