Individual
DR. SUSAN ROBERTA RAYBOURNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Mailing address
6439 GARNERS FERRY RD, COLUMBIA, SC 29209-1638
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
027683
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027638
STATE LICENSE
GA
Enumeration date
07/17/2006
Last updated
07/21/2010
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