Individual
PHILLIPS RUTH DERIDDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9 RICHLAND MEDICAL PARK DR STE 530, COLUMBIA, SC 29203-6870
(803) 434-4603
(803) 434-7983
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
LL52457
SC
208000000X
Pediatrics Physician
LL52457
SC
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
52457
SC
Other
Enumeration date
06/20/2018
Last updated
12/08/2025
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