Individual
MARY AUSTEN STODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6000
Mailing address
512 CARPENTER ST, CHARLESTON, SC 29412-2707
(843) 441-2089
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
28956
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/26/2023
Last updated
07/01/2024
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