MEDICARE: RUTH SCHIRMER DE HAVEN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208D00000X	General Practice Physician	16710	SC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841265220
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RUTH SCHIRMER DE HAVEN M.D.

Provider Business Mailing Address
First Line	:	1249A SAVANNAH HWY
Second Line	:	ST. ANDREWS MEDICAL, INC
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7826
Country	:	US
Telephone Number	:	843-763-2000
Fax Number	:	843-763-2325

Provider Business Practice Location Address
First Line	:	1249A SAVANNAH HWY
Second Line	:	ST. ANDREWS MEDICAL, INC
City	:	CHARLESTON
State	:	SC
Zip	:	29407-7826
Country	:	US
Telephone Number	:	843-763-2000
Fax Number	:	843-763-2325

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2006
Last Update Date	:	02/29/2008

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