MEDICARE: DR. NED T RUPP 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
1	207K00000X	Allergy & Immunology Physician	19514	SC

Other Identifiers

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

General Provider Information

NPI Number	:	1750360178
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NED T RUPP M.D.

Provider Business Mailing Address
First Line	:	7555 NORTHSIDE DR
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-4211
Country	:	US
Telephone Number	:	843-797-8162
Fax Number	:	843-820-1300

Provider Business Practice Location Address
First Line	:	7555 NORTHSIDE DR
Second Line	:
City	:	NORTH CHARLESTON
State	:	SC
Zip	:	29420-4211
Country	:	US
Telephone Number	:	843-797-8162
Fax Number	:	843-820-1300

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	11/17/2015

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