Individual
MR. RONNIE R SMALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
300 SINGLETON RIDGE RD, CONWAY, SC 29526-9142
(843) 347-8037
Mailing address
PO BOX 829, CONWAY, SC 29528-0829
(843) 347-8037
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R17210
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN0435
—
SC
Enumeration date
04/11/2007
Last updated
12/10/2007
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