Individual
NATHAN HUDEPOHL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MPH
Contact information
Practice address
701 GROVE RD FL 1, GREENVILLE, SC 29605
(864) 455-7899
(864) 455-5474
Mailing address
1 INDEPENDENCE PT STE 212, GREENVILLE, SC 29615-4536
(864) 797-6328
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
57012072
OH
207P00000X
Emergency Medicine Physician
Primary
82067
SC
207P00000X
Emergency Medicine Physician
MD13199
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001772601
RI MEDICARE
RI
01
—
08-01-2010
UNITED HEALTHCARE
RI
01
—
08-26-2010
NHPRI
RI
01
—
09/28/2010
TUFTS HEALTH PLAN
RI
01
—
09282010
BCBSRI
RI
05
—
110086375A
—
MA
01
—
939025129
RI MEDICARE GROUP
RI
05
—
NH81987
—
RI
01
—
P00871028
RI MEDICARE RR
RI
Enumeration date
05/25/2007
Last updated
07/15/2019
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