Organization
TRICIA ETHERIDGE, MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TINA MARIE MURDAUGH (OFFICE MANAGER)
(843) 726-6773
Entity
Organization
Contact information
Practice address
109 S GREEN ST, RIDGELAND, SC 29936-9165
(843) 726-6773
(843) 726-6778
Mailing address
PO BOX 999, RIDGELAND, SC 29936-2616
(843) 726-6773
(843) 726-6778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19547
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42D1028556
CLIA
SC
01
—
50017139
TAT
SC
05
—
GP3946
—
SC
05
—
L25587
—
SC
Enumeration date
01/02/2007
Last updated
03/07/2023
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