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Individual

DR. NICKOLE RUCKER TEEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1700 SKYLYN DR, SPARTANBURG, SC 29307-1041
(864) 573-3000
Mailing address
PO BOX 2295, ASHEVILLE, NC 28802-2295
(828) 398-5244
(828) 360-3080

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
2014-00944
NC
207L00000X
Anesthesiology Physician
Primary
38068
SC
390200000X
Student in an Organized Health Care Education/Training Program

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
380689
SC
Enumeration date
06/29/2011
Last updated
05/19/2017
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