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General NPI Number Information
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NPI Number | 1720062102
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Entity Type | Individual
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Provider Name | ELLEN CARRIE RIEMER MD
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Gender | Female
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Dates
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Enumeration Date | 11/30/2005
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Last Update Date | 11/12/2020
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Provider Practice Location Address
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Address Line | 171 ASHLEY AVE
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City | CHARLESTON
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State | SC
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Zip | 29425-8908
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Country | US
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Telephone | 843-792-4032
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 751461
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City | CHARLOTTE
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State | NC
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Zip | 28275-1461
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Country | US
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Telephone | 843-792-6200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 31454
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 31454
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 200300874
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License Number State | NC
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Taxonomy #4
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 200300874
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License Number State | NC
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