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Individual

DR. PRUDENCE C MBU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3000 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-1442
(803) 395-2200
Mailing address
PO BOX 1245, ORANGEBURG, SC 29116-1245
(803) 395-4497
(803) 395-2237

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
38825
SC
207R00000X
Internal Medicine Physician
MD44169
TN
208000000X
Pediatrics Physician
MD44169
TN

Other

Enumeration date
07/13/2007
Last updated
01/09/2017
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