Individual
DR. STEPHEN R. RIDGEWAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657
Mailing address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
18553
SC
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
18553
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
185533
—
SC
01
—
8157
MEDICARE PTAN
SC
Enumeration date
05/01/2006
Last updated
07/23/2014
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