Healthcare Provider Details

I. General information

NPI: 1407745896
Provider Name (Legal Business Name): ERIKA ELIZABETH LUDDEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2025
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

169 ASHLEY AVE RM 202
CHARLESTON SC
29425-8905
US

IV. Provider business mailing address

96 JONATHAN LUCUS ST CSB 301, MSC 606
CHARLESTON SC
29425-0001
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-3222
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMMD.94976LL
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: