Individual
DR. REBECCA BRAZELL RIDENHOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2728 SUNSET BLVD STE 201, WEST COLUMBIA, SC 29169-4837
(803) 254-1300
(803) 771-7579
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
30670
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306706
—
SC
Enumeration date
08/17/2007
Last updated
11/11/2020
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