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Individual

DR. SUZANN HUTTO WEATHERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
87 SPRINGVIEW LN, SUMMERVILLE, SC 29485-9077
(843) 876-7979
Mailing address
PO BOX 602108, CHARLOTTE, NC 28260-2108
(843) 792-6200

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28868
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
288682
SC
01
5277
MEDICARE GROUP #
SC
01
GP1551
MEDICAID GROUP#
SC
Enumeration date
11/09/2006
Last updated
08/07/2019
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