Individual
DR. RICHARD SIGURD LARSON III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
2067 CHARLIE HALL BLVD, CHARLESTON, SC 29414-5834
(843) 573-2535
Mailing address
850 BLUFF RIDGE LN, BELLEVILLE, IL 62221-3562
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
23287
SC
Other
Enumeration date
10/17/2019
Last updated
04/27/2022
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