Waddle, Dudley M

Waddle, Dudley M is an individual health care provider with primary practice located at 132 Professional Park Dr Unit A , Conway SC 29526-9268. He recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Community Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is his primary health care specialty. Waddle, Dudley M can be contacted via phone (843) 347-4900.

Contact Information

Primary practice address
132 Professional Park Dr Unit A Conway SC 29526-9268
Phone: (843) 347-4900
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Community Health 163WC1500X APN14935 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN14935 Tennessee
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 18521 South Carolina

Profile Details

NPI number 1942520705
LBN Legal business name Waddle, Dudley M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 3rd, 2010
Last updated Sep 18th, 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 1942520705 NPPES
South Carolina MEDICAID NP2575

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