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General NPI Number Information
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NPI Number | 1598711814
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Entity Type | Organization
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Legal Business Name | SUZANNE D. RENFRO M.D., PA
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/13/2007
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Provider Practice Location Address
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Address Line | 130 ROCKINGHAM RD
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City | GREENVILLE
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State | SC
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Zip | 29607-3621
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Country | US
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Telephone | 864-422-1793
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Fax |
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Provider Business Mailing Address
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Address Line | 130 ROCKINGHAM RD
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City | GREENVILLE
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State | SC
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Zip | 29607-3621
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Country | US
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Telephone | 864-422-1793
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUZANNE D. RENFRO
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Credential | M.D.
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Telephone | 864-422-1793
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 17600
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License Number State | SC
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