Individual
MRS. MARY ETHEL ROEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
200 PATEWOOD DR, STE B 100, GREENVILLE, SC 29615-3593
(864) 451-5200
Mailing address
8 AUTUMN OAK WAY, TRAVELERS REST, SC 29690-4066
(864) 836-6151
(864) 836-6157
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R59124
SC
367500000X
Certified Registered Nurse Anesthetist
Primary
R59124
SC
Other
Enumeration date
01/18/2006
Last updated
04/16/2013
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