Individual
MRS. STEPHANIE CAROL BRUNDAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
130 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 233-1534
(864) 751-6020
Mailing address
130 MALLARD ST, GREENVILLE, SC 29601-4046
(864) 233-1534
(864) 751-6020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14338
SC
Other
Enumeration date
10/25/2006
Last updated
07/09/2007
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