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NPI Code Detail

MEDICARE: DR. ROCHELLE C RUTLEDGE M.D.

MEDICARE: DR. ROCHELLE C RUTLEDGE 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
1207Q00000XFamily Medicine Physician9305SC

Other Identifiers

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

General Provider Information

NPI Number : 1699750893
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROCHELLE C RUTLEDGE M.D.
Provider Business Mailing Address
First Line : 306 STATION 22 1/2 ST
Second Line :
City : SULLIVANS ISLAND
State : SC
Zip : 29482-9756
Country : US
Telephone Number : 843-883-3176
Fax Number : 843-883-3176
Provider Business Practice Location Address
First Line : 306 STATION 22 1/2 ST
Second Line :
City : SULLIVANS ISLAND
State : SC
Zip : 29482-9756
Country : US
Telephone Number : 843-883-3176
Fax Number : 843-883-3176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 01/27/2021

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