Individual
DR. ALICIA RUTH SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
620 SINGLETON RIDGE RD, CONWAY, SC 29526-9154
(843) 347-7300
(843) 347-8459
Mailing address
300 SINGLETON RIDGE RD, ATTENTION PATIENT ACCOUNTING, CONWAY, SC 29526-9142
(843) 234-6946
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
87204
SC
207YS0123X
Facial Plastic Surgery Physician
0101263595
VA
207YS0123X
Facial Plastic Surgery Physician
87204
SC
207YX0007X
Plastic Surgery within the Head & Neck (Otolaryngology) Physician
Primary
87204
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
872041
—
SC
Enumeration date
03/10/2006
Last updated
08/02/2022
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