Healthcare Provider Details

I. General information

NPI: 1598896847
Provider Name (Legal Business Name): SUSAN REED DDS, MPH, DRPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2007
Last Update Date: 09/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 ASHLEY AVE # MSC917 MEDICAL UNIVERSITY OF SOUTH CAROLINA
CHARLESTON SC
29425-9170
US

IV. Provider business mailing address

201 COTTON PLANTERS CT
CHARLESTON SC
29412-8307
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1577
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number3142610
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: