Individual
DR. MARC G RUCQUOI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 724-2450
(843) 724-2455
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
131910
NC
207Q00000X
Family Medicine Physician
Primary
21172
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
141M4
BLUE CROSS BLUE SHEILD NC
NC
05
—
5902852
—
NC
05
—
L31972
—
SC
01
—
P00813760
RAILROAD MEDICARE ID-RSFPN
SC
Enumeration date
09/05/2006
Last updated
10/20/2015
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