Individual
KEVIN H ROERDEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
501 ROBERTSON BLVD, WALTERBORO, SC 29488-2787
(843) 549-0720
(843) 549-6254
Mailing address
PO BOX 869, FOLLY BEACH, SC 29439-0869
(843) 588-6378
(843) 588-6378
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1996
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AN1284
—
SC
Enumeration date
07/16/2006
Last updated
07/09/2007
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