Individual
STEPHANIE RADU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-3499
Mailing address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-3499
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A772140
DRIVER LICENSE
OR
Enumeration date
03/01/2019
Last updated
03/18/2024
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